Local Health Content in Nigeria Blends Tradition and Science

---

In his contribution to a DFID-funded local content study, John Dada illustrates how communities in Nigeria are using new ICTs to document traditional healthcare knowledge.

---

Nigeria has about 120 million inhabitants, 70% living in rural communities where there is limited access to health and other information. With little disposable income, and the prohibitive cost of hospital bills and medication, many people in rural communities have turned to traditional medicine. This trend initially looked to be a setback for health workers. However, it also presents an opportunity to work with the health knowledge possessed by local people, especially women.

In recent years, the Fantsuam Foundation has worked with rural women to try to understand various traditional healthcare practices and, where appropriate, to introduce 'best practice' and safer techniques.

The project recognises the role of traditional medicine, especially in communities where it is the only healthcare available. It also recognises the often-ignored strategic roles of women as primary caregivers in these communities. The project is entirely driven by the communities and its participatory approach has allayed suspicion of any attempt to undermine traditional medicine or bring it into disrepute. Fantsuam Foundation has previously built up significant credibility with the rural communities through its poverty alleviation programmes. This has made it easier to negotiate access with significant stakeholders in the communities for the project.

The Fantsuam Foundation is a group membership organisation. The members are established women's groups in rural communities in Kaduna State. Fantsuam has a membership of about 80,000 and provides indirect benefit to over 700,000 people through its microcredit and community learning centre programmes.

The content is a classified description of the common treatments used for common ailments in local communities. These communities have a largely oral tradition with very little information in written form. This project is the first attempt to document their traditional health knowledge and skills. So far, information has been categorised in the following areas: Communal hygiene (sewage disposal and drainages), types of fevers, 'bad back' (a musculo-skeletal problem experienced by many middle-aged farmers), leprosy, female genital mutilation, dysmenorrhoea, diet-control in diabetes and hypertension, non-sexual transmission of HIV/AIDS through use of unsterilised razors for circumcision and facial tribal marks, and hygienic preparation of traditional recreational drugs (these are stimulants prepared from tree barks).

Common treatments used by traditional healers include the emollients and local anesthetics of the traditional bone setters, and the use of herbs as an inhalant during labour, to stimulate lactation, and to treat ringworm. In the Kafanhan area where we work, there is no record of collaborations with research departments of the local universities to investigate the biomedical properties of these treatments.

The communities, especially the older members, generate all information held in the catalogue. Such knowledge remains the property of the communities.

A medical database is under development for each participating community. This was initially conceived as a vital registration database (births and deaths), but it now incorporates a traditional pharmacopoeia specific to that community. The information is stored on CDs and hard disk and is in the custody of the Village Head.

We do not use a 'pure' model comprising solely indigenous health information. Invariably, we find there are always elements of western scientific knowledge that can be rafted to an indigenous health practice to make it safer and more efficient.

In addition to the knowledge and information collected from the population, other sources of health information are regularly consulted for information that can be adapted and grafted into the existing body of local knowledge and practices. The health channel of the WorldSpace Radio, Satelife, WHO fact sheets, and numerous discussion lists are translated into the local dialect and shared with the women.

In negotiating access for the project, the Fantsuam Foundation gave an assurance that local knowledge will not be disseminated without the approval of the communities. This condition also applied to the knowledge and skills of specific individuals. This was the community's copyright procedure.

Information sharing is not a problem commonly encountered among the ordinary villagers. There is a willingness to do this with nearby villagers and even with researchers from outside. Much information is common to other rural communities and is usually freely shared among members of the tribe and to outsiders as well. It is the traditional healers who feel threatened by dissemination of their knowledge and skills. Healers are aware of the pool of knowledge that their communities share, and the people still consult them because they are believed to have specialist skills, more advanced knowledge and ability to access supernatural sources of information for various diseases as well as social, political and economic problems. In Nigeria the healers now have an association that acts like a trade union primarily to regulate how information is shared with non-practitioners

Some lessons:

• Start with the knowledge base available within the community and build from there
• Developing local content cannot stand alone - it should be conducted within the context of a wider community health programme to facilitate its sustainability
• It is possible to evolve an information management system that preserves traditional knowledge and practices while making it receptive to new ideas about healthcare.
• Traditional medical knowledge has aspects that can be modified and improved for better healthcare delivery.
• Local content that is largely determined by the host community has a better chance of being adapted, upgraded and improved through additional external information from orthodox medicine.
• Traditional knowledge is amenable to modernisation if the effort is one of partnership. Intellectual property rights can be safeguarded while making the knowledge available to all members of the host community
• It is important to have access to regular updates of reliable health information from a variety of sources
• There is a need for local capacity for the translation of externally generated information from sources such as textbooks, newspapers, journals and the Internet into the local dialect.

Please contact John Dada at the email address below for more information.