CHAPTER ONE

INTRODUCTION

          The use of herbs to cure illness is as old as man. This is because the existence of man is not without one form of ill health or the other. The evolution of man through pre historic, neolithic, medieval, and colonial and postcolonial times has been attached to one form of medical facility or the other. 

          In Africa, plants and herbs play major roles in addressing health challenges before the advent of the Arabs, Europeans, Christian missionaries and the eventual colonialization of the continent. The case of malaria, which saw to the death of many European visitors to Africa, did little harm to the people of Africa. The coming of quinine as drug for malaria was in actual sense not the first break through in addressing malaria. For example, dogoyaro, paw-paw leaf, lemon grass are used in preparing drugs for malaria before the discovery of quinine.

          Unfortunately, the coming of colonialism altered people’s health practices. The colonialist in their racial superiority created the impression that presented orthodox medicine as superior to African medicinal sciences. During the colonial period, missionaries and colonial authorities worked hand-in-hands in the introduction of medical treatment e.g the construction of lyienu Hospital Ogidi, Mile 4 Hospital Abakaliki and RCM Hospital in Afikpo. This development provided a platform for people to seek medical attention in western built hospitals.

          Inspite of the efforts to establish western medical care, no genuine effort was put in place to develop traditional medicine alongside the modern hospital. For example, Elizabeth Isichei captured the feelings of an Igbo native doctor turned Christian as follow:

In Igboland, as in other parts of the world, the history of disease and its treatment, and of epidemics, is an important and neglected variable in social history. The real achievements of pre-colonial African societies in the sphere of medicine are now generally recognized. Even today, traditional dibia include some superbly successful bone-setters, and pharmacologists in Nigeria (and elsewhere in West and East Africa) are conducting a scientific analysis of traditional herbal remedies.¹

Furthermore, she continued:

In this connection we might well remember a certain Chive of Igbariam. Chive was a former dibia who had become a Christian, and suggested to the local missionary in 1921 that a university of medicine should be established, where Dibia could hand on their medical knowledge, in isolation from the corpus of traditional religious beliefs. The missionary snubbed the proposal, telling Chive how organized society regarded quacks.²

The reply of the missionaries is not different from that of the colonial administration since they are both propagators of western ideologies. For example, the recent increase in bone related cases calls for a revistation of the need for a synergy between orthodox and traditional medicine. This is because of the increase in modern transportation system such as vehicles, aero plane, motorbike, popularly called “Okada” have lead to increase in victims of bone related fractures. As will be discussed in this research, the traditional bone setting have proved itself viable more than western orthodox medicine in this regard. This is evident of few testimonies of peoples who got healed from the traditional hone setters. Unfortunately, in spite of its efficacy, the Federal, State and Local governments have not deemed it appropriate to integrate the bone setting industry into the orthodox medicine. However, throughout colonial rule, A report recorded as follow:

A closer examination of the Nigerian healthcare system sheds some light on why it has been particularly difficult to integrate contemporary western orthopedics with indigenous practices. The first hospital in Nigeria was established in 1873. However, the hospital was established primarily by the European colonials with the intent to primarily treat “their own”. It took another 40 years until Nigerians could actually use that hospital and even then only select elite Nigerians were welcomed. Similarly, when the National Orthopadedic Hospital were established, they were intended solely for Europeans. Nigerian physicians only began to receive training in orthopedic after the country’s independence from Great Britain in 1960.³  

Traditional bone setting methods are systematic. First step is to identify whether a fracture is opened or closed. For closed fractures, the bonesetters identify the fracture using palpation and clinical signs.⁴

This study is divided into five chapters namely introduction, the second chapter deals on the land and people of Enugu, the third chapter is traditional bone setting centers in Enugu, the fourth chapter is on the development of the health sector in Enugu and the fifth chapter is the summary and conclusion.

Scope of the Study

This  study covers the period between 1975-2015. The take off date of 1975 is remarkable because it was on 4 April 1975 that Government of East Central state named after Emperor Haile Selassie of Ethopia as Haile Selassie Institute of Orthopedic, plastic and ophthalmic surgery.

The terminal date 2015 was selected to re-examine forth years of the administration of the Orthopedic Hospital Enugu and its service to the people. Furthermore, the dominant role played by the Goodluck Jonathan administration which came to an end in 2015 is worth examining by historians.

This study covers the geographical space of the Enugu urban, which accommodates many patients and practitioners in bone related challenges both orthodox and traditional.

Source and Methodology

In historical study, two major sources exist. They are the primary and secondary sources. The primary study includes oral interviews, news papers and the internet google search engine. The research will adopt the descriptive style of historical analysis by conducting interviews on health personnel’s both in the orthodox hospitals selected for this study. On the other way round, there will be visit of the traditional bone setting attendants in selected places in Enugu State.

Furthermore, the views expressed by medical experts will be collaborated into the frame work of analysis in this research. This will exist in objective assessment of the development relating to the traditional bone setting. There are specialized hospitals in Enugu Urban that deserve the attention of this research. The National Orthopedic  Hospital as well as the university of Nigeria Teaching Hospital Ituku –Ozalla will serve useful purpose  for this research the writer intends to interrogate medical experts of bone related developments.

Literature Review

Alternative medicine has been part of the people’s culture before the arrival of the Europeans. As part of its civilizing mission, Lawal observed that the Christian missionaries  saw traditional medicine as superstition belonging to witch doctors and charlatans. In spite of the efforts of the nationalists to kick against westernization, no remarkable achievement was put in place in regards to improving traditional medicine. Colonial medical schools succeeded in training nurses doctors, dentist with western orientations. Furthermore, scholars who published works on health and medicine did not provide basis for the reading public to accept anything from the traditional medicine as useful. Furthermore, government budgets allocations on health focuses more on training of medical personnel at home and oversees building more hospitals with utter neglect of the traditional medicine research.⁵

In an empirical research, A.M Udosem, O.O. Ote,  O. Onuba wrote on the role of traditional bone setters in Africa: Experience  in Calabar. The authors are medical experts of the department of surgery, university of Calabar. They studied eight centers of bone settings in Calabar and administered questionnaires to about ninety two persons. They observed that there is erroneous belief that the only available option. For the treatment of fractures in hospitals is amputation. The  authors observed that ignorance was a factor in the patronage of people in traditional bone setting as majority of the patients were illiterate motorcyclists they argued that traditional bone setting use the same method of herbal cream application, native bamboo splinting frequent pulling and massage and complications such as tetanus, gangrene and germs are usually attributed to charms and withcrafts they accused traditional bone setters of lacking basic knowledge of anatomy and physiology, as a result of this, they suggested an outright legislation against patronizing traditional bone setters.⁶

Mathew O. Egwu, Vincent CB. Nwuga and Mathew O.B Olagun’s paper on therapeutic philosophy of some Bonesetters, argues differently from A.M Udosen and others already reviewed. They observed that python fat; shear butter, palm oil, herbs and roots were used as medium for massage and healing. The success of the traditional bone setters include in their stretching of posterior longitudinal ligament causing pain relief. They observe that traditional Bonesetters manages various orthopedic conditions through conventional technique, uses incantations and other psychological support to get healing. They concluded that traditional Bonesetters are ignorant of basic physiology of inflammation and arterial supply. However, they expresses confidence that  traditional Bonesetters enjoy immense training in the physical and mental healing and thus, if trained be a great asset since there is absence of most qualified orthopedics compared to the ration of patients who need their assistance.⁷

Relevant to this study, Nnamdi Emmanuel Omeire’s “Indigenous Orthopedic medicine: A case study of the buckets”. Using a traditional           bonesetting center in Emiyi Owerri, author interacted with patients receiving treatment during the period of his research and they continued that they were already penciled down for amputation if not for the Iweke healing home. In all, the author asserts that the Iweke traditional medicine has exposed the qualitative level of ignorance that pervades the orthodox medicine. According to him, orthopedic sugeries in the hospital were unnecessary if doctors have knowledge of how to hand pick and set bones.⁸

V.R Adebimpe wrote on the ambivalence of westernized professional towards traditional medicine. He concluded that for western-trained practioners to continue to cover importance of traditional medicine, is for them to operate with a false sense of self-sufficiency and to love with complete self  knowledge.⁹ Next to Adebimpe’s work is M.M Iwu’s Igbo Ethromedicine, he outlined the various typologies of Igbo medicine men to include Dibia Afa (Diviners) Dibia Ngboro-ogwu (Herbalists), Dibia Ogbanje (in charge of evil spirits and paediatic diseases). Dibia owu Nmiri (in charge of river goddesses), Dibia Ogba- Okpukpu (Orthopaedic injuries) Eze mmuo (witch sacrifices). Of particular interest to this  study, is the author’s  analysis on Igbo Orthopaedic medicine. After examining 84 cases of clinically rated major fractures, the writer informs us that the art of preparing fractures and other orthopaedic injures is almost parallel to  the European or western method of   orthopaedic treatment. The author noted that apart from the use of wooden splints to immobilize the fractures the herbs used and the incantations are not customary with European medicine. A fundamental difference is the use of hot applications of pepper and other spices in bonesetting in situations where the European doctors would prescribe cold compressions.¹⁰

George .E. Simpson offers an insight into Yoruba Religion and medicine in Ibadan. Beginning from the Native Doctors Association. According to his revelations their exist remarkable difference between herbalists, babalawo and other diviners. Herbalists according to him uses medical history and symptoms for diagnosis. The common methods of preparations made of mixtures of roots, leaves, barks, fruits, parts of animal and so forth, and rituals involving offering to the Orisa or the witches. However, one of the remarkable revelations of the study shows that trained medical experts at Ibadan in most cases accept that plants are capable of curing ill-health.”¹¹

All the texts reviewed add to our knowledge of the topic in so many ways. However, there are basic gaps that our study of traditional bone  medicine practice in Enugu state attempts to address. Enugu is reputable for hosting two teaching hospitals, many private hospitals and a national orthopedic hospital. The relationship between the aforementioned hospitals and the traditional bone setting centers have not received the attention it deserves from historians. Historians  appear to address more of political and economic issues and pay little attention to evaluating the commitment of the traditional bonesetting in the development of the health sector.

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