Orthodox Medical Practitioners Research Articles

An Ethnographic Study on Clergymen Concerning the Aetiology and Management of Mental Illness in South Western Nigeria

Background: The clergy plays an important role in the care of mentally ill people in developing countries because of the predominant belief that supernatural factors are responsible for mental illness and spiritual healers are sought by the mentally ill and/or their relatives for treatment. This study aimed to assess clergymen’s beliefs about the etiology and treatment of mental illnesses in southwest Nigeria.
 Methods: The study was qualitative design and ethnographic in nature, conducted on one hundred and forty-eight clergymen at the Nigerian Baptist Theological Seminary, Ogbomoso, Nigeria. A convenient sampling technique was used and Self-administered questionnaires to obtain sociodemographic details. An In-depth/Semi-structured interview involving Focus group discussions (FGD) and key informant interviews (KII) was used for the study. Data were analyzed using SPSS version 20. The sociodemographic variables were presented on a frequency table.
 Results: The study involved hundred and forty-eight respondents with male preponderance. From the focus group discussion and key informant interview, respondents believed that mental illness depends on the victim’s predispositions and could as well result from spiritual attacks directly or indirectly through or from ancestral lineage, genetic factors, or evil forces. Although most of the respondents argued that mental illness is caused solely by spiritual attacks and can only be treated by spiritual means like an exorcism. However, the majority believed that a holistic approach to treatment must involve the spiritual, psychological and medical.
 Conclusion: The factor of theological education shines through in the definition, recognition, treatment, the concept of cure and clergy role in the management and community advocacy for mental illness although within the context of cultural beliefs of supernatural etiology of mental illness. With improved knowledge and their holistic approach to care, the clergymen will be able to effectively work with the orthodox medical practitioners in a wholesome way through an effective referral system, ensuring compliance, rehabilitation and banishing discrimination.

Medical doctors do not know it, nor can they treat it: Identifying the common neonatal illnesses and preferred healthcare practices in a Yoruba community, Nigeria

Background: Prompt and effective healthcare practice is essential to reducing neonatal morbidity and mortality which is at a higher rate among low-income nations including Nigeria, especially in rural settings. Studies have identified some structural factors such as poverty and limited healthcare resources as major factors without giving adequate attention to the related intrinsic factors such as peoples‟ understanding and beliefs among other cultural factors that could encourage or hinder effective healthcare practices for the neonates which is the gap of this study intends to fill. Methods: First-hand data were collected during a six-month rapid ethnographic fieldwork at Akinlalu using various qualitative methods of data collection including observations, interviews, and discussion among others. The main focuses were the community's social life and activities and socio-cultural structures such as faith homes and healthcare as well as individuals (grandmothers, grandfathers, birth attendants, medical doctors, and childbearing fathers and mothers) involved in family and children's health in this community. Results: Findings reveal an array of neonatal illnesses and interestingly a high level of discordance between the perceived illnesses, causes, and treatment between local people and modern healthcare providers. Widely identified and considered the deadliest neonatal diseases are senukoto, oka, and yiyi (measles). Others mentioned are giri (convulsion), olo-inu, and jedi-jedi. Senukoto is believed to be caused by kokoro (bacteria/germs) and can kill the infected neonate within the first seven days after birth if not adequately treated. Oka, yiiyi, and olo-inu were also considered deadly, usually causing taboos violation while eating sweetening things during pregnancy or breastfeeding is the perceived cause of jedi-jedi. Conclusion: the study concludes that rural dwellers often cast doubt on orthodox medical practitioners in response to childhood illnesses and treatment which in most cases have implications for prompt healthcare seeking and non-adherence to the medically prescribed regimen.

Socio-Economic Importance of Honey among Traditional Healers and Orthodox Practitioners in Iwo Local Government Area of Osun State, Nigeria

The necessity for people’s adequate and quality as well as good health and standard of living for overall National development informed the main reason for the study on Socio-economic importance of honey among traditional healers and orthodox medical practitioners in Iwo Local Government Area, Osun State. A total of 105questionnaires wereadministered, while 91 were retrieved from the respondents. Various uses of honey were investigated both for personal consumption and medicinal purpose. The result shows that 41.8 % of the respondent use honey for multiple purpose, while 35.2% use honey mainly for medicinal purpose, 16.5% use it mainly as beverages, while the remaining 6.6% for use in treatments. The Chi Square Test showed a higher calculated value of 385.71 than the tabulated value of 21.026. This confirms a strong relationship between the use of honey and social life of Iwo people. The major constraints discovered was that Traditional healers do not exercise strict control on the quantity doses of honey used for different ailments. It is therefore recommended that both rural and urban dwellers should be sensitized about the use of honey, in order to encourage sustainable consumption for improvement of health status.
 Keywords: Medicinal, orthodox, traditional, honey

Ebola virus disease in the eyes of a rural, agrarian community in Western Nigeria: a mixed method study

BackgroundEbola virus disease (EVD) is a severe hemorrhagic disease caused by Ebola virus. Several outbreaks have been reported in Africa and often originated from remote agrarian communities where there are enormous misconceptions of the disease, refusal of early isolation and quarantine, and unsafe burial rites practices which aggravates the epidemics. It is on this basis that this study was conducted to (assess) the knowledge, perceptions, beliefs and preventive practices against EVD in a predominantly agrarian rural community in Southwest Nigeria.MethodsThis was a cross-sectional study conducted in Igbogila town, Yewa North Local Government Area of Ogun State, Southwest Nigeria in the latter part of 2014 during the EVD outbreak. Mixed methods were used for data collection. Quantitative data collection was done using a pre-tested interviewer administered questionnaire. Four hundred and seven respondents selected by multi-stage sampling technique were interviewed. Descriptive and inferential statistics were done, and the level of significance was set at 0.05. Qualitative data collection involved four focus group discussions a year after the epidemic was declared over in the country. The discussions were recorded, transcribed and analyzed along major themes.ResultsAll respondents were aware of EVD with radio and television being the major sources of information. Knowledge of the disease was however very poor with many misconceptions and it was significantly influenced by educational level of respondent. EVD survivors will be welcomed back into the community by few residents (36.8%) and a much fewer proportion (27.2%) will freely entertain a survivor in their house. Most would prefer local herbalists over orthodox medical practitioners to care for their loved one in case they contract EVD. Although respondents knew that burying a victim is dangerous, they opposed cremation.ConclusionThere was poor knowledge of EVD with a lot of misconceptions. Community members were not pro-active about prevention with dire consequences in the event of an outbreak. Continuous public education should be done via mass media, traditional institutions and other community-based channels as part of emergency preparedness.

Public Information, Education, and Communication (IEC) of Health: Active Participation of Health Practitioners in Urban Radio in a Low Resource Setting

Introduction:Over the last two decades, Frequency Modulation (FM) radio has been established as the only form of sound broadcasting in Ghana. Radio is the most accessible of mass media. There are more than 40 operational radio stations in the Ashanti region of Ghana. Most stations are commercial, broadcasting in the local language (Asante-Twi). Many urban radio health slots discuss various diseases and their treatments mainly for the benefit of patients. Complementary and Alternative Medicine (CAM) practitioners who are able to pay for airtime dominate as ‘experts’ in most of these shows.Methods:We identified an IEC gap regarding policies governing healthcare delivery, healthcare financing, training, ethics and research, and environmental issues. In June 2015, orthodox medical practitioners collaborated with a private, local, English-speaking radio station to produce and host a weekly health show whose content was aimed at holistically discussing health from the viewpoint of practitioners, clients, policy makers, administrators, and financiers in a simplified language for the general public, including healthcare trainees.Discussion:The show dubbed “Staying Alive” first aired on Tuesday, July 7, 2015, at 20:00 GMT and continues to air to date, appealing to a wide range of active listeners. “Staying Alive” to the best of our knowledge remains the only show with a holistic approach to health. Over the last 23 months, we have experienced challenges in sustaining sponsorship to fund the cost of production and airtime for the show, and the cost of effectively assessing the public health impact of the show. Orthodox medical practitioners can employ mass radio as an effective tool for advocacy, information dissemination, and education of clients or health trainees in low or middle-income urban settings through effective collaboration with media stations.

Sociocultural Context and Determinants of Treatments for Hemorrhoids Among the Nigerian Police, Oyo State Command

Hemorrhoids or piles, culturally known as <em>Jedijedi</em> among the people of southwestern Nigeria, are an anorectal disease surrounded by misconceptions. The consequences of these misconceptions are enormous. Therefore, the main objective of the present study is to understand the sociocultural explanation of piles among selected personnel of the Nigeria Police Force. We recruited 302 police officers for the exploratory survey through a multistage sampling technique. Five key informants were interviewed at the study area based upon their professions and proximity. Data interpretation was done through chi-square and content analysis. Results indicated a high prevalence (73%) of and misconceptions about hemorrhoids among the respondents. The majority (80%) of the respondents had a poor awareness of the risk factors, making a scientifically unfounded claim that sugar intake was responsible for piles. Their belief negatively influenced the treatments adopted. Furthermore, their choice of therapy was influenced by its affordability (<em>p </em>< .05) and the fear of hemorrhoidectomy (<em>p </em>< .05). The study established various misconceptions about hemorrhoids among herbal vendors and police officers, which influenced treatment choices. The study suggested that one potent tool for combating ignorance about the disease is sensitization, which will equip officers to adopt healthier behaviors and aid herbal vendors to give better treatment to their clients. In addition, experimental platforms should be set for herbal vendors and orthodox medical practitioners to form a synergy in combating the diseases.

Reasons for Patronage of Traditional Bone Setters.

Aims and Objectives:The objectives of this study were to analyze the different reasons why patients with fractures patronize traditional bone setters (TBS) and their impression of the outcome of the treatment by the TBS.Materials and Methods:A 24 month prospective observational study was conducted from February 2012 to January 2014. All the patients were recruited from the orthopedics outpatient clinic. The demographic data of each patient, the type of injury, presentation to hospital or not, reasons for leaving the hospital, reasons for patronage of the TBS and their impression of the outcome of TBS’ treatment, effect of educational background on patronage of TBS and reason for presenting to hospital for orthodox treatment.Data Analysis:Analysis was done with SPSS software Version 20.Results:A total 79 patients were recruited for the study and they had different reasons for patronizing TBS. These reasons include an external locus of decision making in 19 (24.1%) patients, and greater faith in TBS compared to orthodox medicine in 16 (20.3%). Twelve (15.2%) believed that TBS are more competent than orthodox medical practitioners while another group 11 (13.9%) considered the fees of TBS cheaper than those in the hospital. The delay in treatment in the hospital, forceful removal of patients from hospital against their will and nonsatisfaction with hospital treatment accounted for 5 (6.3%). Poor attitude of hospital staff, fear of amputation, and patients being unconscious during the injury accounted for 2 (2.5%). Their ages ranged from 17 to 83 years, with mean age of 36.8 ± 11.8 years. The male: female ratio was 1.5:1.Conclusions and Recommendations:With recent advancements in the practice of orthopedics and trauma, there is still a very high patronage of the TBS by most of our patients. This is largely due to the dependence of the patients on their sponsors for treatment, while the influence of cultural and religious beliefs continues to play a major role in these decisions.

Exorcism Practices in South-West Nigeria: A Comparative Analysis

In South-West Nigeria, the indispensability of services of exorcists cannot be overemphasized as there were numerous instances when orthodox medical practitioners, after having done their utmost but unsuccessfully, would advise patients to seek spiritual remedies to their maladies. The exorcists whose services are sought after in the region abound in the three main religions namely Islam, Christianity and Yoruba Traditional Religion. This study is a survey and a comparative analysis of exorcism practices by the Muslim, Christian and Yoruba Traditionalist exorcists in SouthWest Nigeria purposely to determine the possibility or otherwise of interference in their practice of exorcism. Areas of comparison include the personality of the exorcists, their diagnostic methods and the exorcism modus operandi. The result showed that difference in religious calling notwithstanding, there is, to a large extent interference and borrowing in their exorcism modus operandi, since they all operate in the same milieu.

Towards integrating traditional medicine (TM) into National Health Care Scheme (NHCS): Assessment of TM practitioners’ disposition in Lagos, Nigeria

The WHO has proposed the organisation and training of practitioners of TM for PHC (primary health care) services to enable the use of traditional systems of medicine with appropriate regulations based on national health systems. Thus, the traditional medicine practitioners (TMPs) are presently employing a series of strategies to ensure integration of their practices into the National Health Care Scheme (NHCS). This study determined the knowledge of TMPs about their practices. It also assessed their disposition towards ensuring safety measures in their practices towards subsequent integration into NHCS. A descriptive survey was carried out using a WHO standardized questionnaire to obtain the opinion of 170 volunteer TMPs knowledge about their practice in Awolowo market, Odi-Olowo, Lagos, Nigeria. A few (18%) of the respondents believed that herbal preparations have adverse effects. The results further showed that the respondents (64%) were disposed to scientists investigating their herbal preparations. The majority (54%) have the intention to collaborate with orthodox medical practitioners if they have the opportunity. The respondents (76%) believed that levels of education may have roles to play in their practices, while 59% of them have intention to improve their educational status. The Government should ideally constitute a body that will facilitate the integration of TM into NHCS as proposed by the WHO, in order to make health care much more effective in the near future. Traditional and Western medicine are individual valid treatment options, yet each has its limitations and neither of them has all the treatment answers. This integration may enhance safety use of herbal remedies and appropriate practice of TM.

Public Perceptions of the Role of Traditional Medicine in the Health Care Delivery System in Ghana

Background: People from different cultural backgrounds have used different forms of Traditional Medicine as a means to managing their ailments. This study examined public perceptions of the role of Traditional Medicine in relation to the accessibility, conditions treated, safety, efficacy rate and interactions between traditional and orthodox medical systems in the Sekyere South District of Ashanti, Ghana. Methods: This was a descriptive cross-sectional survey. A sample of 70 Traditional Medical Practitioners, 30 health care users, and 20 Orthodox Medical Practitioners were used and selected respectively based on snowball, random sampling and purposive techniques. Both quantitative and qualitative data were collected through administered-questionnaire and in-depth interviews. Non-participant observation was used to assess the working environments of the practitioners in 9 selected communities in the district. Relevant data obtained were analysed using both qualitative and quantitative methods. Percentages and cross-tabulations, using the Predictive Analytic Software (PASW), version i6.0 were the methods used to analyse the data. Findings: The main findings suggest that Traditional Medicine is effective as it was employed in treating numerous medical conditions such as malaria, typhoid fever, arthritis, jaundice, impotency, infertility, stroke, broken bones, boils, piles, HIV/AIDS, mental illness, etc. However, safety of use of the Traditional Medicine is not standardized. Moreover, there is some form of interaction between the two health care providers through cross-referrals though; the cross-referral systems are not coordinated and strictly unofficial. Traditional Medicine is readily available to the people and also less expensive, hence easily accessible. Policy options that seek to address some difficulties and challenges encountered by the practices of Traditional Medicine and improving upon the quality, safety, and standard of service are recommended. Conclusion: The conclusion drawn from the research is that Traditional Medicine is used by many people to managing numerous conditions. It is accessible and effective. It therefore plays a significant role by reducing life-threatening ailments of humanity. This study adds to the scant but growing documented literature about the potentials of Traditional Medicine.

Patterns of complementary and alternative medicine use amongst outpatients in Tokyo, Japan

BackgroundThe use of complementary and alternative medicine (CAM) has been increasing rapidly throughout the world during the past decade. The use of CAM in the general Japanese population has been previously reported to be as high as 76%. This study aims to investigate the patterns of CAM use, perceived effectiveness and disclosure of CAM use to orthodox medical practitioners amongst patients attending typical primary and secondary care clinics in a busy district general hospital in Tokyo, Japan.MethodsThe authors analysed data collected during March 2002 on patients attending general outpatient clinics held at Shiseikai Daini Hospital in Tokyo, Japan. Data was collected by use of self-completed questionnaires distributed to patients in the outpatient clinics waiting area. Statistical analysis was performed using chi-square tests of independence.Results515 adults were approached to participate in this study and the overall response rate was 96% (n = 496). 50% of the patients were using or have used at least 1 CAM therapy within the last 12 months. The 5 most commonly used therapies were massage (n = 106, 43%), vitamins (n = 85, 35%), health foods including dietary supplements (n = 56, 23%), acupressure (n = 51, 21%) and kampo (n = 46, 19%). The majority of CAM users (75%, n = 145) found their CAM treatment to be effective (95% CI = 68–81%). Patients who were more likely to use CAM were females (p = 0.003) and those with a high number of medical conditions (p = < 0.0001). Only a small proportion of patients reported their CAM use to their physician (42%, n = 74). There was no significant difference in CAM use for the different age groups (p = 0.85), education level (p = 0.30) and financial status (p = 0.82).ConclusionPatterns of CAM usage in the sample surveyed was high (50%). Despite this high prevalence rate and presumed acceptance of CAM in Japan, the reporting of CAM use by patients to their physicians was low (42%). It is therefore important that physicians are aware of the possibility that their patients may be using CAM and also increase their knowledge and understanding of these treatments.

The role of the traditional bonesetter in primary fracture care in Nigeria.

In view of the growing interest in the management of fracture worldwide, the traditional bonesetter (TBS) practice in Nigeria was documented. To highlight the role of the TBS in primary fracture care in Nigeria. Rural. Over a 5-year period a qualitative study of the TBS settings and knowledge, diagnostic techniques and principles of fracture treatment in four TBS centres in Nigeria was carried out by active participation, on the spot assessment, interactive dialogues and oral interviews. It was found that TBS services are well preserved as a family practice, and training is by apprenticeship. Records are kept by oral tradition. There is no prescribed fee and the patronage is high. Fracture diagnosis is based on physical assessment and experience. The TBS relies solely on the conservative method of fracture treatment, and all fractures are reduced by the closed method and stabilised with an external traditional splint and a protracted period of immobilisation. The outcome of TBS treatment is good for closed fractures of the shaft of the humerus, ulna, radius and tibia, but poor for peri-articular and open fractures. Non-union, malunion, traumatic osteomyelitis and limb gangrene were the common major complications of TBS treatment. Despite criticisms and antagonism from orthodox medical practitioners TBS practice is well patronised by Nigerians. In order to guarantee safety and efficiency of the TBS practice in primary fracture care service delivery in Nigeria, there is therefore a need both to educate the community and to train the TBS.

A-V Fistulae from Arrow Injuries: A Report of Two Cases

Feathered arrows, representing some of the primeval weapons of man are still being used as violent weapons for settling disputes. Seventeen various cases of cardio-vascular injuries caused by arrow shots were recorded at the University of Maiduguri Teaching Hospital (UMTH) from 1994 to 1998. Of these, one involved the temporal vessels, which led to a temporo-temporal A-V fistula causing the patient continuous noisy headache. The late complication was only recognized about two years post injury. Another arrow shot injury involved femoral vessels and resulted in femoro-femoral A-V fistula, which came to be recognized four yeas post injury. The thigh fistula caused cardio-pulmonary decompensation. The two patients had undergone alternative treatments between orthodox medical practitioners and medicine men both in Nigeria and some other West African countries, prior to presentation at UMTH. Successful surgical vascular repairs restored normal health conditions to the patients. Vascular complications of any missile injury should be recognized early so as to prevent serious complications. Key Words: Arrow, Cardio-vascular, A-V Fistula [Mary Slessor Jnl of Medicine Vol.3(1) 2003: 55-60]

The enslaved healers of eighteenth-century Saint Domingue.

Enslaved healers including herbalists, kaperlatas, hospitalières, infirmières, and accoucheuses existed and flourished in the medical world of Saint Domingue. They were responsible for the creation of an indigenous form of medicine on the island. Using Western, African, and Caribbean remedies, they treated their fellow slaves and white residents of the island. Slaves were more comfortable and more familiar with the care and techniques employed by the popular healers, especially the kaperlatas and the herbalists. Plantation managers took advantage of the labor of female medical workers in order to reap economic profits for their planter employers and for themselves. Lower-class whites, unable to afford and unwilling to consult mainstream medical care, sought the assistance of healers known as kaperlatas. Lastly, orthodox medical practitioners turned to slave healers, especially herbalists, to exploit the therapeutic knowledge that the slaves possessed and, in the case of enslaved midwives, to bring them more closely under the authority of European medical men.

The role of Abraham Lincoln in securing a charter for a homeopathic medical college.

In 1854, Abraham Lincoln was retained to prepare a state legislative proposal to charter a homeopathic medical college in Chicago. This was a complex task in view of the deep-seated animosity between allopathic or orthodox medical practitioners and irregular healers. Homeopathy was regarded as a cult by the nascent American Medical Association. In addition, the poor reputation of medical education in the United States in general, further complicated the project. Lincoln and influential individuals in Illinois lobbied legislators and succeeded in securing the charter. Subsequently, the Hahnemann Homeopathic Medical College accepted its first class in 1860 and with its successors remained in existence for almost sixty-five years.

Productive readings: the portrayal of health "experts" in women's magazines.

This article illustrates how health practitioners are portrayed through advice columns, articles, personal accounts, and advertisements in women's magazines. Magazines provide a valuable source of information about health services and also influence lay knowledge about health and illness. A wide variety of health practitioners provide information and advice in women's magazines, ranging from orthodox medical practitioners to alternative practitioners. However, there is a blurring of boundaries between these, with orthodox practitioners sometimes including alternative therapies in their practice and alternative therapists sometimes encompassing a number of orthodox therapies within their practice. The way health practitioners are represented in the media has implications for how their expertise in health issues is evaluated and used by consumers of health care services.

The Standardization of Bee Venom Solutions

In some countries bee venom has been in regular use for many years for the treatment of certain forms of rheumatism and arthritis, whereas in others it is disregarded, or regarded as a ‘crank’ treatment which orthodox medical practitioners should have nothing to do with.In this complex subject, any advance which enables more exact observations to be made is welcome. Charles Mraz, a well-known American beekeeper who has worked with bee venom since 1935, has now made progress in standardizing bee venom solutions. Details of this test—which will probably become known as the ‘Mraz test for bee venom’—are being published at an early stage so that others can try it out and report on it.

The Folklore of Children's Diseases

THE folklore of children's diseases is very extensive, including as it does popular conceptions of the acute exanthemata and other infectious diseases, especially whooping-cough and diphtheria, rheumatic fever, venereal infections, cardiac, alimentary and respiratory disorders, as well as isolated diseases, especially enuresis, infantile convulsions, rickets, hernia and the supposed effect of the Evil Eye. Time does not allow me to discuss the folklore of all these diseases, some of which I have dealt with elsewhere, but I have tried to select the most interesting material. Aetiology. Belief in the doctrine of maternal impressions, of which numerous examples have been collected by Gould and Pyle,' is still far from extinct, even among medical practitioners, although there is no scientific foundation for such a view. Some years ago 2 1 showed a case of giant naevus of tippet distribution before the Children's Section of the Royal Society of Medicine, in a girl aged seven, whose mother had been frightened in the third or fourth month Qf pregnancy by a black and tan dog. In spite of her doctor's assurance to the contrary she was convinced that the child would be marked, and her surmise proved correct. In the subsequent discussion the president of the section expressed his belief in the reality of maternal impressions, and quoted a similar case. The recognition of astrology by orthodox medical practitioners survived till the eighteenth century, as is shown by Mead's work.3 Kircher (quoted by Pettigrew 4) alluded to the evil effects of a conjunction of Mars and Saturn, which he states emitted very deadly exhalations, and such diseases as small-pox, measles and fever become inevitable. A puny child who does not thrive is often regarded, especially in countries bordering on the Mediterranean, as suffering from a visitation