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ReligionandRestorationofHealthinAfrica.pdf

Chapter 8 Religion and the Restoration of Health in Africa: A

Case Study of the Traditional Akan People of Ghana

Samuel Awuah-Nyamekye

Introduction Sound health, no doubt, is the soul of every human society, for no human society can thrive if her people are afflicted with ill-health. For this reason, the Akan of Ghana prioritise matters that border on sound health. But among the Akan as is the case in traditional African societies, the line between their secular and religious activities is indistinguishable (Parrinder, 1961; Mbiti, 1969; Opoku, 1978.) This makes the hold of religion on the Akan and, for that matter,traditional Africans, very strong.

In the worldview of the traditional Akan2 of Ghana, apote or apomuden (health or well-being) is not only understood as the absence of diseases and afflictions or misfortunes but also, it includes the presence of good relationship between humans and the spirit beings on one hand and good interpersonal relationship on the other, for the Akan one cannot claim there is good health or well-being while the people in the community are at each other’s throat. That is, a good mental framework is inclusive of health in the Akan milieu (Opoku, 1978, Kwame Gyekye, 1996; Awuah- Nyamekye, 211). This mind-set is very common among many African cultures (Gwyneth,. 1994; Makinde 1988:6). This worldview thus, gives direction to the Akan in all their activities including health and its restoration. This also explains the reason why usually the etiology of almost all diseases has supernatural underpinnings (Field, 1961; Foster, 1976). It must, however, be emphasised that in

2 By traditional Akan people, I mean those Akan who generally still keep and live to the customs and traditions of their forebears, particularly their indigenous spirituality (African Traditional Religion) in spite of the influence of impinging religions such as Christianity and Islam

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spite of the supernatural etiology of ill-health among the Akan, they also at some point acknowledge the ‘Germ Theory’ or the ‘naturalistic’ causes of illneses as Foster (1976)puts it.

Notwithstanding this reality, and paradoxically, the Akan still find it very difficult to de-couple spirituality and therapeutic practices. It is against this background that this chapter argues that among the traditional Akan, religion and medicine are inseparable realities. Literature on health care delivery in Ghana is quite extensive but those on how the local concepts of illness may affect people’s choices of health care model are scarce. The discussion is focused on the following themes: Akan conception of medicine, the nexus between religion and medicine, etiological explanation of illness among the Akan and the Akan medical practitioner and the ‘Germ Theory’ and the prospects of indigenous/traditional medicine in Ghana today.

Methodology

This study has benefited from my earlier research on traditional

medicine in Africa particularly in Ghana and personal observation and teaching experience in a course Religion and Medicine in Africa in the Department of Religion and Human Values of the University of Cape Coast for the past ten years. I relied on a variety of qualitative research tools, ranging from focus group discussions (FGD), and individual interviews to document analysis. I interviewed a variety of interlocutors who include traditional African Priests, Traditional Birth Attendants (TBAs), orthodox medical practitioners and traditional medical practitioners.

Who are the Akan?

The Akan constitute the largest ethnic group in Ghana. They

constitute close to half of the population of Ghana. The 2010 Population census of Ghana put the percentage of the Akan in Ghana at 47.5%. They are mainly found in the middle and the southern part of Ghana. They speak the Akan language. The Akan are culturally homogenous and by and large, matrilineal. Akan are

182Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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also found in the south-eastern portion of the Republic of Ivory Coast or La Cote d’Iviore (Warren 1986:7; Odame Beeko, 2005)3.

3 For more details on the Akan see: Warren, Dennis M. 1986. The Akan of Ghana: An overview of Ethnographic Literature. Pointer Limited; Beeko, Odame Eric. 2005. Creative Processes in Akan Musical Cultures: Innovation Within Tradition. A Ph.D. dissertation, University of Pittsburgh; Adu Boahen, A. in Colloque Inter- Universitaire Ghana- Cote-D’ Ivoire : Les Populations , in Colloque Inter- Universitaire Ghana- Cote-D’ Ivoire : Les Populations Communes De La Cote D’Ivoire Et du Ghana, Bondoukou, 4 - 9 Janvier, 1974, pp. 66-81Pobee, J.S. 1979.Toward an African Theology. Abingdon/Nashville.

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Medicine among the Akan Medicine, as practised by the Akan of Ghana, is part of what

has become known today as traditional or indigenous African medicine. Traditional medicine has been defined variously by various interest groups and scholars, such as WHO, Parrinder, 1961; Field, 1961; Opoku, 1978; Domfe, 2007). According to Domfe (2007:42), traditional medicine refers to ways of protecting and restoring health that existed before the arrival of modern medicine. He further argues that ‘these approaches to health belong to the traditions of each country, and have been handed down from generation to generation’(ibid.). Evans-Anfom (1984:11) reports that a group of experts from the World Health Organization (WHO) sub-region of Africa who met in Brazzaville in 1976 defined African traditional medicine as:

The sum total of all the knowledge and practices, whether

explicable or not, used in diagnosis, prevention and elimination of physical, mental and social imbalance and relying exclusively on practical experience and observation handed down from generation to generation, whether verbally or in writing. Evans-Anfom (1984:11) again reports the same world body,

WHO, as having viewed traditional African medicine as:

Traditional African medicine might also be considered to be the sum total of practices, measures, ingredients and procedures of all kinds, whether material or not, from which time immemorial had enabled the African to guide against diseases, to alleviate his sufferings and to cure himself. A careful analysis of the two definitions from WHO shows that

they are underpinned with Euro-American categories as the ensuing discussion will show.

In the Euro-American societies, the word medicine has a limited usage. It is any drug or substance, which is taken to cure an illness. For the Akan, however, the word ‘medicine’ has shades of meaning (see Twumasi 1979; Reynolds 1996.) For instance, it is

184Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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literally translated in Akan as ‘aduro.’ Literally, the word aduro may have the same meaning as the West understands medicine to be. However, for the traditional Akan, ‘medicine’ goes beyond the physical substances that are used to treat diseases (Twumasi, 1975; Opoku, 1978; Awuah-Nyamekye, 2011). Generally, medicine is understood as involving all the indigenous techniques for restoring and maintaining health, which have been developed and used over the years. These techniques are heavily influenced by their cultural and religious beliefs, and are passed on from generation to generation until the advent of the modern conventional methods of restoring and maintaining health (Reynolds, 1996, Awuah- Nyamekye, 2011, Mawere, 2011). The Akan also view medicine in its broader sense as any power that can have a supernatural influence over other powers. In this case then, witchcraft, magic and sorcery are integral parts of medicine in the traditional Akan sense (see Awuah-Nyamekye, 2008, Mawere, 2011). Medicine may also be understood to be any means used to ply the supernatural realm for information, which otherwise could be hidden from ordinary eyes. This explains the reason why in Akan traditional societies, those who practice medicine are mainly those believed to have the ability to communicate with the spiritual world.

Today, this kind of medicine is known among the Akan of Ghana as Abibiduro, which literally means ‘African Peoples’ medicine.’ The term was designed by scholars, particularly social anthropologist to differentiate between the African way of treating illnesses from that of the Euro-American societies when colonialism and its attendant Westernisation was introduced to the Africa.

Who is a traditional medical practitioner?

Again, just as it is not easy to arrive at one acceptable definition

of traditional medicine (Evans-Anfom, 1986) so also it is with traditional medical practitioner or healer as the concept is looked at from different perspectives. According to the WHO a traditional healer is:

A person who is recognized by the community in which he lives as competent to provide health care by using vegetable, animal and

185Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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mineral substances, and certain other methods based on the social, cultural and religious background as well as on the knowledge, attitudes, and beliefs that are prevalent in the community regarding physical, mental and social well-being, and the causation of disease and disability (cited in Evans-Anfom, 1986:12).

The above decription of traditional healer can be described as comprehensive, however, in the worldview of the people under study, the role of religion in the practice of medicine is emphasised. Nana Agyemang, a well known tradtional healer in the Berekum area describes a traditional healer in the following words:

Traditional medicine man/woman (healers) is a person who

usually through the aid of the spiritual powers supported with training, and experience has gained a deep knowledge of herbs of all kinds and other necessary materials and their permutations for the purposes of treating those who are afflicted with disease of all kinds in his or her society. Such individual’s expertise covers many areas such as mental problems, bone setting, midwifery, skins rashes and other diseases that affect humans (Nana Agyemang, personal communication, January 18, 2013). Nana Agyemang further explains that the ability to ply into the

spirtual world is a necessary ingredient for any successful traditional healer since many diseases in the Akan society are believed to have spitirual undertone. What this implies is that a healer, can be exposed to attack from the source(s) of the ailment if he/she (healer) is not spiritually fortified. That is, as a healer you must know how to protect yourself and that of your client(s) from spiritual attacks. Karim et al’’s (1994) study among the Zulus of South Africa reveals a similar finding (see also Mawere, 2011). It is against this background that Twumasi (1988) defines traditional medicine as ‘a practice in which there is no conceptual separation between natural and supernatural entities. It entails a holistic method utilising medico-religious acts and concepts’ (Twuamasi, 1988:9 cited in Setswe, 1999: 57). This explains why religion is an important aspect of Akan medical culture. In the follwing

186Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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paragraphs, I discuss how religion and medicine move together among the Akan. The nexus between Religion and Medicine

I have already pointed out that religion plays a vital role in the

life of the Akan.. This explains why religion has been one of the key elements in the process and restoration of health among the people under study. The specific elements of religion that often feature in health delivery system among the Akan include: God, divinites, ancestors, and other spirit beings such as Mmotia (dwarfs or fairy of the forest). The role of religion in the restoration of health in traditional African societies has been underscored by other studies (Osborne 2003; Foster, 1976; Hammond-Tooke,1989). Osborne (2003) for instance, observes that indigenous African healing stems from ancient, fundamental, philosophical and religious beliefs… and that their concerns about bodily well-being cannot be separated from their spiritual beliefs.

Among the Akan, and indeed, as it is the case among other traditional African peoples, God for instance, is viewed as the ultimate source of all human needs. Medicine for instance, in Akan worldview, is viewed as a gift from God and dispensed through the agency of the divinities (Twumasi, 1975; Awuah-Nyamekye, 2011:72). In traditional Akan society, God is recognised as the giver and healer of all ailments, and hence, the saying: ‘Onyame ma wo yare a, oma wo aduru’ ‘If God gave you sickness he also gave you medicine’ (Rattray, 1923:142). It is thus common to hear traditional Akan medical practitioners always telling their clients when consulted that ‘if God permits you will be well.’

The other religious entities that feature actively in the restoration of health among the Akan are the deities. The evidence of the role deities play in health delivery among the Akan can be seen in the names of these deities borne by people in traditional Akan societies. The most common Akan names that are compounded with names of deities include: Asirifi, Apee, Bo , Kune Kru, Mframa and Nyamaa and many others. River deities are also important source of restoring health among the Akan people such that it is very common to find people throughout Akan society

187Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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bearing names such as Asub nten, Bosomtwe, Kom , Densu, Densua, Pra,Praba, Tano,Tanoa —all bodies of water in the Akan land. These names result from either the parents of the children involved consulted these river deities before the conception of the children or the deity involved healed the child of a serious ailment of some sort.

Furthermore, it is very common in Akan society to see people consulting the deities for the treatment of diseases of all kinds. Tan Kwasi, the state god of Berekum Traditional Area for instance, is noted for her prowess in handling infertility problems. Other studies elsewhere in Africa also reveal that deities play a role in medicine. Opoku (1978) also reports that Osanyin Yoruba god and Agwu of the Ibo of Nigeria, are recognised as the guardians of medicine, and are believed to call or possess people to become medicine men and women.

Other spiritual entities that are believed to have a role to play in the practice of medicine in the traditional Akan society are the ancestors. Quite a number of the traditional medicine men/women I interviewed claimed that they received their calls through their grandparents in dreams. It is interesting to note that it is not only among the Akan that Ancestors play a role in medical practice. According to Idowu (1973), Elesije an important figure in Ile-Ife society in Nigeria is viewed as the first doctor and the ancestral genius of medicine who is always invoked in the treatment of diseases among the people of Ile-Ife in Nigeria. Four of my informants claimed that they became medical practitioners through abduction by Mmotia ( dwarfs or fairy of the forest).

My field work and personal observations as well as teaching experience show that the training process of the traditional medical practitioners indicate an affinity between religion and medicine among the people under study. This is because the category of people who dominate in the practice of medicine in traditional Akan societies and, indeed, all traditional societies in Ghana are mainly ritual specialists such as diviners, priests, prophets, mediums, and magicians. Most of these traditional medical practitioners usually claim they acquire their knowledge through: dreams, visions, voices, and abduction by dwarfs, possession, inheritance, apprenticeship and other means (Opoku, 1978; Awuah-Nyamekye,

188Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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2011). To illustrate this, I present below an account of one of my key interlocutors who became a priest/diviner and, consequently, traditional medical practitioner4

I became Benyaade komfo when my maternal uncle died. Immediately after he died, I was sent through a series of rituals. I was made to bath with a concoction in a brass pan (yaawa) in the morning, afternoon and the evening for three consecutive days. The concoction was prepared with the following herbs: guakro (Ageratum conyzoides), atanogya, mee (Ocinum canum), nunum (Ocinum viride) and piaa (Hyptis brevipes). There was another herb known as awenade (Akotopotsin), which was put into my bath water to be used seven times daily for three days. After this ritual bath, the juices of another set of herbs were dropped on my eyes. These were asinsan (Cynodon dactylon) and nkrangyedua (Jatropha carcass).Then sacred emblem was put on my head for six hours daily for three consecutive days. On the third day, there was a splash on my eyes. I began to shiver profusely. I fell down and became dumb. Asinsan, one of the herbs, which were dropped on my eyes, was mixed with other herbs and put into my mouth and I was sent to the outskirts of the village. An egg was given to me. I threw it against at a tree and mentioned the name of my dead uncle, komfo Adum and greeted him three times: komfo Adum makye oo!, komfo Adum makye oo komfo Adum makye oo! This means: Priest Adum good morning Priest Adum good morning Priest Adum good morning. This was explained to mean that I have successfully gone through the training. Customarily, it was said that the trainee-priest should be able to mention the name of an ancestor of the family and greet him or her when he or she is regaining his or her speech. But if he should mention the name of a person who is living, that person, it is believed, will soon pass away. After these rituals, I could understand the language of my deity Benyade. I was told the training should have lasted for three years but since I had served as an attendant under my uncle for more than six years, I was formally trained for three months. This was how I became a diviner/medicine man (Awuah- Nyamekye, 2011:75).

4 This is because in traditional societies, all traditional priests are medical practitioners since medicine is an important aspect of the curriculum that a traditional priest goes through during his or her training:

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Even the way the ingredients of the medicine are collected and prepared—performance of certain rituals before plucking some herbs and the healing processes involved--point to the connection between religion and medicine. Mawere and Andile study among indigenous South Africans in this volume confirms the affinity between religion and medicine thus: ‘In South Africa, traditional healers are mainly indigenous Africans with spiritual gifts to treat various conditions (ailments/diseases) including resolving many other health related problems.’ In the words of Twumasi (1975: 35) ‘the distinction between physical cure and magico-religious cure is not usually made since the diagnosis and the treatment of illness are deeply embedded in the utilisation of the supernatural.’

Another important aspect of medicine that can be used to demonstrate the close affinity between religion and the practice of medicine in the study area as has been hinted earlier, is the causative agents of illnesses. The Akan etiology of illness

The general worldview of the Akan regarding the causes of

illnesses could be put under three broad categories— (a)Supernatural, (b) human causes and (c) natural causes or what is referred to now as ‘germ theory’. Even in the case of the human causes, it is believed that the human agent(s) make(s) use of the supernatural to cause the illness. That is why the supernatural or the ‘personalitic’5 causes seem to be dominant among the Akan (see Turner 1967; Mutungi 1977; Mawere 2011). The interaction with my key interlocutors revealed the following as the principal means through which illnesses, afflictions or misfortunes resulting from supernatural origins can occur:

i. Neglecting one’s religious duties ii. Breaking of taboos

5 According to Foster (1976: 775) ‘personalistic’ etiology of illness is the belief that illnesses are principally caused by the ‘active purposeful intervention of an agent, human (witch, sorcerer), non-human (ghost, ancestor, evil spirit), or supernatural (deity or powerful being)’.

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iii. Engaging in evil activities iv. Activities of witches and sorcerers NNeglecting one’s relig ious duties Nana Fosua (personal communication, January 4,. 2013)

contends that the Akan culture can be described as a ‘religious culture’ and thus religious activities, particularly religious duties cannot be ignored in the day to day activities of the Akan. Therefore, any traditional Akan that thinks otherwise does so at his or her own peril. Specifically, she emphasises that there is no way an Akan can refuse to give due recognition to the ancestors and the gods. Hence, due recognition is given to Nananom nsamanfo (Ancestors) among the Akan. This she says manifests itself in the sacrifices and libation that take place on sacred days such as Adea6, and annual festivals that centre around the blackstools7 in the stool rooms and gods in the various Akan communities. What this means is that if a person falls sick and the sickness deifies medical treatment, one plausible ways to explain it is to suspect that the person may have neglected his or her religious duty. The suspicion becomes stronger if the individual concerned is a community leader or an Abusuapanyin (family head). This is because one of the main duties of an Abusuapanyin is to see to feeding of Nananom nsamanfo by way of offering them sacrifices on behalf of other family members.

Breaking of taboos

6 Adae in Akan language simply means the sleeping place of the ancestors. But now the concept refers to a sacred day (and in fact, a festival among the Akan ) on which the Akan remember their ancestors by offering them food and drink of all kinds. For more details on Adea see Opoku, 1978: 39-43.

7 Among the Akan, every chief is supposed to have a stool, known as as s dwa, which is usually made from s s dua plant (Funtumia sp.). It is this stool that is blackened and placed in a special room called nkondwafieso [‘stool room’] after the death of a chief. Therefore, all the important rituals connected with the ancestors centre around these stools. In fact, the stool is the symbol of a chief’s office. Any chief whose stool is not blackened and placed among those of his or her predecessors is not a recognised chief among the Akan (Nana Kwabena Wusu, personal communication, 12 October 2011, at Nana Takyiwaa’s palace in Senase).

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The institution of taboos has been a commonplace practice in many African societies since time immemorial. A taboo, according to my informants, is any act that is strictly prohibited in the Akan society infraction of which attracts the wrath of the either the ancestors or the gods of the community concerned. Mawere and Kadenge (2010:29) have given a comprehensive description of what taboos are. They contend that taboos serve: [a]s codes of conduct/commandments and indigenous knowledge systems (IKS) and beliefs that helped in preserving the natural environment, peace, order and the integrity of African societal structures. The word “taboo” is a derivation from the Polynesian term tabu, which simply means “forbidden.” According to Sarpong (1974: 51), it may be applied to any form of prohibition. The Akan word for taboo is mmusuo. Among the Akan, the breaking of certain categories of taboos such as committing murder or suicide, seducing someone’s wife are considered as sin. (Awuah-Nyamekye, 2012). In the view of

komfo Tawia (personal communication, September, 13, 2013), an infraction of a taboo constitutes a sin, and always attracts divine wrath until the spiritual entity involved is propitiated through confession and the performance of the necessary sacrifice(s).

EEngaging in evil activities The Akan believe in retribution, hence, the saying that kromfo

bi ara wu wo nensa ano. This literally means ‘Every thief dies at his/her own hand.’ That is, the evil doer dies in his or her own iniquities. For this reason, many Akan use curses as means to cause afflictions of all forms to those who steal their properties especially valuable property like gold ornaments, clothes and others items considered precious. Rivers Koraa in Berekum, Antoa Nyamaa in Antoa, Pata Angye in Tarkwa in the Brong-Ahafo. Ashanti and Western Regions of Ghana respectively are noted for their ability to retrieve stolen items for their owners through affliction they cause to the perpetrators (the thieves) .Men who chase other people’s wives can also suffer through curses. Among the Akan, sipe—the harbouring of anger, bitterness and resentment against others for no justifiable cause—is another source of inviting troubles for oneself.

192Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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AActivities of witches and sorcerers As I have already explained, traditional/indigenous medical

practitioner as a necessity must be spiritually fortified. This means that one should have a good knowledge of how to manipulate the forces of nature to protect either oneself or one’s clients—This is the knowledge of counter magic. That is, traditional medical practitioner has the capacity to deploy medicine either for a good or bad purpose (sorcery). However, among the Akan, it is only the good use of medicine that is acceptable, for it is that which makes life liveable. For this reason, sorcerers (adutofo ) and witches (abayifo ) are viewed as enemies of society. Because of this, when illness befalls one in the Akan society, the activities of sorcerers become one of the suspected causes. Activities of witches and sorcerers are feared in the Akan societies so much so that the people have a saying that: Mensuro nea ob kum me se nea onya me a b s e me. This is literally translated as ‘I am not afraid of the one

who will kill me than one who will destroy me.’ Nana Adjei (personal communication) explains further that the destruction ( s e) here may refer to tarnishing one’s image but when the Akan utters such words, the emphasis is more on those who use witchcraft or sorcery to cause affliction to people. Mawere’s (2011) study of makes similar findings.

I should however point out that although witchcraft (bayie) is generally abhorred in indigenous Akan society, the Akan, however, make a distinguish between what they referred to as bayi pa (good witchcraft) and bayi b ne (bad witchcraft) or sorcery--simply the use of one’s medicine or spiritual power (s) to cause harm to others (Awuah-Nyamekye, 2008). They have no problem with those who use their witchcraft power for good purposes such as healing the sick, protecting children and property and other desirable things in society in general. On the hand, it is bayi b ne (bad witchcraft) or sorcery that is seriously abhorred in Akan society due to the harm that is associated with it. This means that and as Mawere (2011:093) points out, ‘a qualitative difference between witchcraft and sorcery is normally drawn’ in indigenous African societies. Mawere (2011: 100), thus, complicates ‘the view that witchcraft is a metaphysical practice that can only be deployed to cause harm and despondency in society’. Among the Akan, however, the problem is that it is

193Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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believed that it is more likely for those who have the capacity to use the craft to abuse it such as using it for personal gains or to cause discomfort to unsuspecting peoples that is why witchcraft is generally abhorred among the Akan.

The Akan generally believe that the human person is a compound of both material (physical) and immaterial (spiritual) and such, the two must be in harmony or else illness will occur (see Osei 1976). Therefore, whenever there is ill health, it must be tackled at both the physical and the spiritual levels. The logical implication from this worldview (etiology of illness) of the Akan is that the effective means to deal with ailments emanating from spiritual source lies in the same source. That is, through spiritual means. This is the reason why divination mostly precedes traditional medication, while rituals like prayer; libation and sacrifice usually feature in the traditional healing process. This is meant to appeal to or appease the supernatural agent(s) responsible for the sickness.

The Akan medical practitioner and the ‘Germ Theory’

It is important to point out that in spite of the close affinity

between religion and medicine among the Akan as discussed above, they are also aware of the differences between what may be termed as psychologically motivated diseases and or naturally motivated diseases—known conventionally as ‘Germ Theory’. The Germ theory, according to Encyclopaedia Britannica, states that in medicine, ‘certain diseases are caused by the invasion of the body by microorganisms, organisms too small to be seen except through a microscope.’ This theory was proposed and developed in the mid- 16th century. Its widespread credence was credited to Louis Pasteur (The French chemist and microbiologist), Joseph Lister (the English surgeon) and Robert Koch (the German physician) (http//www.britannica.com/EBchecked/topic/230610/germ theory). It is this concept of the causes of diseases that Foster (1976) refers to as ‘naturalistic’ or the scientific aspect of healthcare. What is being emphasised here is that, as pointed out by komfo Agyemang (personal communication, October 20, 2012), ‘we know that if one fails to keep personal hygiene one can get sick out of that and also we are aware of environmentally polluted-related

194Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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diseases such; Asthma, Cholera, Diarrhoea, Dysentery, Typhoid and many others. In these cases, we do not resort to magico-religious rituals when restoring health.’ My interaction with some indigenous Akan medicine men and women in the area also revealed that they are even aware of what modern medicine refers to as placebo.8 In addition, despite the fact that many herbs or cures for ailments are obtained from the supernatural source, they also know that the knowledge of many cures particularly herbs could be acquired through close observation of nature and practical experiences. In some instances, healing techniques or the application of certain herbs has become common knowledge due to their usage over time such that there is no need to consult a specialist when such herbs are being applied. Herbs such as ‘akyeampong weed’ (Chromolaena odorata) for stopping excessive bleeding and the leaves of the nim tree (Azadirachta Indica) for curing fever are common knowledge among the Akan (Opoku, 1978; Awuah-Nyamekye, 2011). Opoku (1978: 154) for instance, has listed other practical means of acquiring and applying traditional medicine in Ghana.

Paradoxically, in spite of this knowledge of the Akan people, they hardly separate pure medicine from metaphysics. This confirms Idowu’s (1973:201) view that ‘...unconsecrated medicine has no meaning for Africans.’ In the words of Mbiti (1989:165), ‘modern hospitals may deal with the physical side of diseases, but there is the religious dimension of suffering which they do not handle…’ Merging traditional medicine with modern medicine can be termed ‘integrated’ approach to healing in the African traditional societies. Consequently one can argue that one cannot say for certain that a traditional medical system among the Akan and, for that matter, among other traditional societies in Ghana and probably beyond will, in the near future, completely do away with religion since their traditional understanding of illnesses and other forms of afflictions are explained in spiritual terms. It is, therefore, not a surprise that despite the widespread criticism of the practice of sending sick people to the religious centres instead of

8 something prescribed for a patient that contains no medicine, but is given for the positive psychological effect it may have because the patient believes that he or she is receiving treatment, Microsoft Encarta.2007. © 1993-2006. Microsoft Corporation.

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conventional medical facilities, people still keep on sending their sick relatives to the religious centres in Ghana. This has implication for health care policy-makers since it has been found out that the worldview of a people plays a fundamental role in their health matters and as such

The prospects of indigenous/traditional medicine in Ghana today

Traditional medicine is confronted with a lot of challenges. For

instance, the foregoing discussion points out clearly that the indigenous religion--African Traditional Religion--of the people is the bedrock of traditional medicine, but this is a religion that has been subjected to serious attack since Christianity was introduced to Ghana as part of the colonial project. Followers of Christianity denounced (and continue to denounce) traditional African religion. African Traditional Religion is labelled as false religion and superstition. What this means is that the very foundation of traditional medicine is under serious siege. Some Churches even suspend their members for soliciting traditional medicine because traditional medicine is mostly associated with traditional priests and rituals such as libation and sacrifices that usually accompany the practice.

The introduction of scientific or orthodox medicine is another major challenge to traditional medicine. The introduction of orthodox medicine has brought about a serious competition between these two modes of restoring health in traditional Akan society and, for that matter, in traditional Ghanaian societies. Orthodox medicine seems to have gained the upper hand in this competition due to favourable support that it gets from the successive governments of Ghana (Twumasi, 1975). Twumasi (1975) reports that as far back as 1878, the then colonial government of Ghana passed a legislation in favour of orthodox medicine which led to an aggressive campaign to liquidate traditional medicine in the country. Although, there has been a shift from being aggressive to traditional medicine in the country in the recent years, for instance, successive governments have recognised the importance of traditional medicine. In 1975 for instance, the Centre for Scientific Research into Plant Medicine (CSRPM) was

196Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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established. A unit under the CSRPM was set up as a follow up to coordinate traditional medicine in the country. This has metamorphosed into what is now known in Ghana today now ‘Traditional and Alternative Medicine Directorate’. In 1992, the government set up the Food and Drugs Board (FDB) to certify the sale of traditional medicine products to the public. TMPC Act, Act 575 was enacted in 2000 to establish Traditional Medicine Council. This Council was tasked to register all Traditional Medical Practitioners in the country. The above moves are definitely positive but the big issue is that the traditional medical practitioners are not backed by law as it is the case for the orthodox medical practitioners. Closely connected to the above is that the traditional healers are not permitted to issue medical certificates to their clients for excuse duty to employers. The lack of the political will of successive governments of Ghana according to an experienced traditional medical practitioner (personal communication, 12 February 2013) is due to the pressure from the orthodox medical practitioners in the country who always approach traditional medicine with suspicion. This claimed appears to be true as Evans- Anfom (1986), a Western trained medical practitioner in Ghana once admitted that it is not easy for medical practitioner trained in the scientific method to treat the subject of traditional medicine entirely objectively and without bias.

One major criticism that is often levelled against traditional medicine is the way it is prepared. It is argued that the stuffs are usually prepared in an unhygienic condition. (see Evans-Anfom. 1986;Twumasi, 1975. Again, there is the problem of dosage and side effect. At times, the dosage is too much. This obviously will not appeal to buyers.

The infiltration of quack traditional medical practitioners into the practice has also been a serious challenge to traditional medicine practice in Ghana. The consequence has been that people now tend to perceive traditional medicine with scepticism. Many of my informants complained about buying fake traditional medicine from people who claimed to be traditional medicine men/ women. Most of them claimed they bought the medicine in vehicles while travelling. Fake practitioners are cashing in from unsuspecting public. This has been so because even though there is a body in

197Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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place to register traditional medical practitioner throughout the country, the monitoring has not been the best as admitted by Nana Kusi, an experienced Herbalist (personal communication, May 2012).

Another major factor that impedes the development of traditional medicine is the rapid destruction of the country forests by bushfire and activities of illegal timber contractors. Herbs, bark or roots of plants and parts of some animals are the key ingredients of traditional medicine but in Ghana today over 80 percent of the forest cover has been destroyed (Tamakloe, 2008). This has affected the easy access to the major ingredient of traditional medicine.

Formidable as the above challenges appear to be, it is difficult for one to say that the prospects of traditional medicine is bleak. This is because in spite of these onslaught against the use of traditional medicne, it remains popular among many Ghanaians today due to its easier accessibility and affordability especially in the rural communities (Twumasi, 1975; Domfeh, 2007; Kgoatla, 1997) Athough there are a lot of moderrn facilities for health delivery in the urban centres, a respectable number of urban dwellers still resort to traditional medicne due to high prices associated with treatments at these modern facilities.

The sankofa ideology9 that is being preached throughout the conutry in some ways re-orient people’s mind against neglecting their culture. Some now argue that the way forward for national development is to go back to the country’s cultural heritage. One significasnt impact of the sankofa ideology is the recognition that traditional religion has received over the years. As of now, African Tradtional Religion is taught in most of the major theologicasl instituitions including the Trinity College, which trains pastors for Methodist, Presbyterain and the Anglican Churches in Ghana. All the major Roman Catholics Seminaries in Ghana offer courses in African Traditional Religion. The religion is taught at all levels of education including PhD in Ghana and in some Euro-American universities. What this means is that people’s attitude towards the religion will/is changing in favour of African Traditional Religion.

9 Sankofa means going back for it. That going back for the cultural heritage of Ghana but with an appraisal with the view to identifying those cultural practices that fit into current realities.

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This means people’s opposition to it (the religion) being associated with traditional medicne will also change accordingly.

One positive development is that today, some herbal medicines for treating various kinds of diseaeses are certified by Food and Drug Board and can found be in Pharmaceutical shops throughout the country. The certification implies that the issue of unhygienic condition perceived to be associated with traditional medicine has been dealt with. Such traditional medicines include, Malaherb, Living Bitters--for treating malaria, and creams such as Akobalm, Mercy cream, Angels cream, Messia Ontiment—for treating skin diseases of all kinds--and many others. Herbalists (another name for the traditional medical practitioner in Ghana) also sell their medications in moving vehicles all over the country. There some clinics in Ghana which deal mainly in tradtional medicines. Some of which include, Taweed, Aponkye clinic in Accra, the national capital.

The coming together of all the traditional medical practitioners under one umbrella—Ghana Fedreation of Traditional Medicine Practitioners(GHAFTRAM)--is a healthy sign for the development of tradional medicine. This means the problem of fake practitioner may be reduced and at the same time, members can now champion their concerns through one recognised body. Recently during the inaugulation of the Greater Accra Branch of the association, the Nana Kwadwo Obiri, the National Organiser of GHAFTRAM took the opportunity to appeal to the govermnent to involve their members on the education being given to health workers on the Ebola epidemics for according to him ‘ our members are usually the first point of contact when there is the outbreak of any disease’ (culled from Daily Graphic, 17th October edition).

All these point to the fact that traditional medicine will be with the Akan, and Ghanaians in general for a very long time if not forever.

199Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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Conclusion In this chapter, I have emphasised that religion permeates the

entire life of the traditional Akan people and, for that matter, the phenomenon of religion may be described as an irreducible element in the way of life of the Akan. This explains the reason why religion is a key factor in Akan therapeutics practices. However, in spite of the strong influence of traditional religion on Akan medical practice, there is still room for what has become known today as the ‘Germ Theory’. That is, traditional Akan therapeutics or medical culture does not only consist of personalistic but naturalistic as well, although the personalistic dimension is more prominent in this people’s medical culture. The discussion has pointed out that apote or apomuden (health or well-being) is broadly understood in traditional Akan milieu, to include the presence of good relationship between humans and the spiritual beings as well as good human- human relationship and good mental framework. It has also been pointed out that traditional medicine is confronted with many challenges but the people have not abandoned it due to practical reasons. Furthermore, the discussion has emphasised that the worldview, particularly the faith of a people plays a role in their health matters and as such, if a healthcare delivery system is to succeed in Ghana then, the worldview of the people must be taken into consideration when designing a healthcare delivery model in the country.

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203Mawere, Munyaradzi, and Awuah-Nyamekye, Samuel, eds. Between Rhetoric and Reality : The State and Use of Indigenous Knowledge in Post-Colonial Africa. Cape Town: Langaa RPCIG, 2015. Accessed March 26, 2018. ProQuest Ebook Central. Created from uwinnipeg on 2018-03-26 20:20:15.

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