Lawrence Lacks Elsie Lacks (1939–1955) David "Sonny" Lacks Jr. Deborah Lacks Pullum (1949–2009) Zakariyya Bari Abdul Rahman (born Joseph Lacks)
Parent(s)
Eliza (1886–1924) and John Randall Pleasant I (1881–1969)
Henrietta Lacks (born Loretta Pleasant; August 1, 1920 – October 4, 1951) was an African-American woman whose cancer cells are the source of the HeLa cell line, the first immortalized human cell line
and one of the most important cell lines in medical research. An
immortalized cell line reproduces indefinitely under specific
conditions, and the HeLa cell line continues to be a source of
invaluable medical data to the present day.
Lacks was the unwitting source of these cells from a tumor biopsied during treatment for cervical cancer at Johns Hopkins Hospital in Baltimore, Maryland, U.S., in 1951. These cells were then cultured by George Otto Gey who created the cell line known as HeLa, which is still used for medical research.
As was then the practice, no consent was obtained to culture her cells,
nor were she or her family compensated for their extraction or use.
Lacks grew up in rural Virginia. After giving birth to two of
their children, she married her cousin David "Day" Lacks. In 1941 the
young family moved to Turner Station, near Dundalk, Maryland, in Baltimore County, so Day could work in Bethlehem Steel at Sparrows Point. After Lacks had given birth to their fifth child, she was diagnosed with cancer.
Tissue samples from her tumors were taken without consent during
treatment and these samples were then subsequently cultured into the
HeLa cell line.
Even though some information about the origins of HeLa's
immortalized cell lines was known to researchers after 1970, the Lacks
family was not made aware of the line's existence until 1975. With
knowledge of the cell line's genetic provenance becoming public, its use
for medical research and for commercial purposes continues to raise
concerns about privacy and patients' rights.
Personal life
Henrietta Lacks was born Loretta Pleasant on August 1, 1920, in Roanoke, Virginia, to Eliza and Johnny Pleasant. Her family is uncertain how her name changed from Loretta to Henrietta, but she was nicknamed Hennie. When Lacks was four years old in 1924, her mother died giving birth to her tenth child. Unable to care for the children alone after his wife's death, Lacks' father moved the family to Clover, Virginia,
where the children were distributed among relatives. Lacks ended up
with her grandfather, Tommy Lacks, in a two-story log cabin that was
once the slave quarters on the plantation that had been owned by
Henrietta's white great-grandfather and great-uncle. She shared a room with her nine-year-old cousin and future husband, David "Day" Lacks (1915–2002).
Like most members of her family living in Clover, Lacks worked as
a tobacco farmer starting from an early age. In 1935, when Lacks was 14
years old, she gave birth to a son, Lawrence Lacks. In 1939, her
daughter Elsie Lacks (1939–1955) was born. Both children were fathered
by Day Lacks. Elsie Lacks had developmental disabilities and was described by the family as "different" or "deaf and dumb".
On April 10, 1941, Day and Henrietta Lacks were married in Halifax County, Virginia.
Later that year, their cousin, Fred Garrett, convinced the couple to
leave the tobacco farm in Virginia and move to Maryland where Day Lacks
could work at Bethlehem Steel in Sparrow's Point. Not long after they
moved to Maryland, Garrett was called to fight in World War II.
With the savings gifted to him by Garrett, Day Lacks was able to
purchase a house at 713 New Pittsburgh Avenue in Turner Station. Now
part of Dundalk, Turner Station was one of the oldest and largest
African-American communities in Baltimore County at that time.
Living in Maryland, Henrietta and Day Lacks had three more
children: David "Sonny" Lacks Jr. (b. 1947), Deborah Lacks Pullum (born
Deborah Lacks; 1949–2009), and Joseph Lacks (1950). Henrietta gave birth
to her last child at the Johns Hopkins Hospital in Baltimore in
November 1950, four and a half months before she was diagnosed with
cervical cancer.
Around the same time, Elsie Lacks (Henrietta and Day's daughter born in
1939), was placed in the Hospital for the Negro Insane, later renamed Crownsville Hospital Center, where Elsie died in 1955 at the age of 15 years old.
Illness
Diagnosis and treatment
On
January 29, 1951, Lacks went to Johns Hopkins, the only hospital in the
area that treated black patients, because she felt a "knot" in her
womb.
She had previously told her cousins about the "knot" and they assumed
correctly that she was pregnant. But after giving birth, Lacks had a
severe hemorrhage. Her primary care doctor tested her for syphilis, which came back negative, and referred her back to Johns Hopkins. There, her doctor, Howard W. Jones, took a biopsy of the mass on Lacks' cervix for laboratory testing. Soon after, Lacks was told that she had a malignant epidermoid carcinoma of the cervix. In 1970, physicians discovered that she had been misdiagnosed and actually had an adenocarcinoma. This was a common mistake at the time and the treatment would not have differed.
Lacks was treated with radium tube inserts
as an inpatient and discharged a few days later with instructions to
return for X-ray treatments as a follow-up. During her treatments, two
samples were taken from Lacks' cervix without her permission or
knowledge; one sample was of healthy tissue and the other was cancerous. These samples were given to George Otto Gey, a physician and cancer researcher at Johns Hopkins. The cells from the cancerous sample eventually became known as the HeLaimmortal cell line, a commonly used cell line in contemporary biomedical research.
Death and burial
On
August 8, 1951, Lacks, who was 31 years old, went to Johns Hopkins for a
routine treatment session and asked to be admitted due to continued
severe abdominal pain. She received blood transfusions and remained at
the hospital until her death on October 4, 1951. A partial autopsy showed that the cancer had metastasized throughout her entire body.
Lacks Town Road in Clover, Virginia, near where Lacks grew up and is buried
Lacks was buried in an unmarked grave in the family cemetery in a
place called Lackstown in Halifax County, Virginia. Lackstown is the
name that was given to the land in Clover, Virginia, that was originally
owned by slave-owning members of the Lacks family in the antebellum South.
Lacks's exact burial location is unknown, but the family believes
that it is within a few feet of her mother's grave site, which for
decades was the only one in the family to have been marked with a
tombstone. In 2010, Roland Pattillo, a faculty member of the Morehouse School of Medicine who had worked with George Gey and knew the Lacks family, donated a headstone for Lacks. This prompted her family to raise money for a headstone for Elsie Lacks as well, which was dedicated on the same day. The headstone of Henrietta Lacks is shaped like a book and contains an epitaph written by her grandchildren that reads:
Henrietta Lacks, August 1, 1920 - October 4, 1951
In loving memory of a phenomenal woman,
wife and mother who touched the lives of many.
Here lies Henrietta Lacks (HeLa). Her immortal
cells will continue to help mankind forever.
Eternal Love and Admiration, From Your Family
Medical and scientific research
Dividing HeLa cells in culture. The cells can be seen metaphase and telophase, different stages of cell division.
George Otto Gey, the first researcher to study Lacks's cancerous
cells, observed that her cells were unique in that they reproduced at a
very high rate and could be kept alive long enough to allow more
in-depth examination.
Until then, cells cultured for laboratory studies survived for only a
few days at most, which wasn't long enough to perform a variety of
different tests on the same sample. Lacks's cells were the first to be
observed that could be divided multiple times without dying, which is
why they became known as "immortal." After Lacks' death, Gey had Mary
Kubicek, his lab assistant, take further HeLa samples while Henrietta's
body was at Johns Hopkins' autopsy facility. The roller-tube technique was the method used to culture the cells obtained from the samples that Kubicek collected.
Gey was able to start a cell line from Lacks's sample by isolating one
specific cell and repeatedly dividing it, meaning that the same cell
could then be used for conducting many experiments. They became known as
HeLa cells, because Gey's standard method for labeling samples was to
use the first two letters of the patient's first and last names.
The ability to rapidly reproduce HeLa cells in a laboratory
setting has led to many important breakthroughs in biomedical research.
For example, by 1954, Jonas Salk was using HeLa cells in his research to develop the polio vaccine. To test his new vaccine, the cells were mass-produced in the first-ever cell production factory. Additionally, Chester M. Southam,
a leading virologist, injected HeLa cells into cancer patients, prison
inmates, and healthy individuals in order to observe whether cancer
could be transmitted as well as to examine if one could become immune to
cancer by developing an acquired immune response.
HeLa cells were in high demand and put into mass production. They were mailed to scientists around the globe for "research into cancer, AIDS, the effects of radiation and toxic substances, gene mapping, and countless other scientific pursuits". HeLa cells were the first human cells successfully cloned in 1955, and have since been used to test human sensitivity to tape, glue, cosmetics, and many other products. Since the 1950s, scientists have grown as much as 50 million metric tons of her cells, and there are almost 11,000 patents involving HeLa cells.
In the early 1970s, a large portion of other cell cultures became
contaminated by HeLa cells. As a result, members of Henrietta Lacks's
family received solicitations for blood samples from researchers hoping
to learn about the family's genetics in order to differentiate between
HeLa cells and other cell lines.
Alarmed and confused, several family members began questioning
why they were receiving so many telephone calls requesting blood
samples. In 1975, the family also learned through a chance dinner-party
conversation that material originating in Henrietta Lacks was
continuing to be used for medical research.
The family had never discussed Henrietta's illness and death among
themselves in the intervening years but with the increased curiosity
about their mother and her genetics, they now began to ask questions.
Consent issues and privacy concerns
Neither
Henrietta Lacks nor her family gave her physicians permission to
harvest her cells. At that time, permission was neither required nor
customarily sought. The cells were used in medical research and for commercial purposes. In the 1980s, family medical records were published without family consent. A similar issue was brought up in the Supreme Court of California case of Moore v. Regents of the University of California in 1990. The court ruled that a person's discarded tissue and cells are not their property and can be commercialized.
In March 2013, researchers published the DNA sequence of the genome of a strain of HeLa cells. The Lacks family discovered this when the author Rebecca Skloot informed them.
There were objections from the Lacks family about the genetic
information that was available for public access. Jeri Lacks Whye, a
grandchild of Henrietta Lacks, said to The New York Times,
"the biggest concern was privacy - what information was actually going
to be out there about our grandmother, and what information they can
obtain from her sequencing that will tell them about her children and
grandchildren and going down the line" . That same year another group
working on a different HeLa cell line's genome under National Institutes of Health
(NIH) funding submitted it for publication. In August 2013, an
agreement was announced between the family and the NIH that gave the
family some control over access to the cells' DNA sequence found in the
two studies along with a promise of acknowledgement in scientific
papers. In addition, two family members will join the six-member
committee which will regulate access to the sequence data.
Recognition
A historical marker memorializing Henrietta Lacks in Clover, Virginia
In 1996, Morehouse School of Medicine held its first annual HeLa Women's Health Conference. Led by physician Roland Pattillo,
the conference is held to give recognition to Henrietta Lacks, her cell
line, and "the valuable contribution made by African Americans to
medical research and clinical practice". The mayor of Atlanta declared the date of the first conference, October 11, 1996, "Henrietta Lacks Day".
Lacks's contributions continue to be celebrated at yearly events in Turner Station. At one such event in 1997, then-U.S. Congressman from Maryland, Robert Ehrlich, presented a congressional resolution recognizing Lacks and her contributions to medical science and research.
In 2010, the Johns Hopkins Institute for Clinical and
Translational Research established the annual Henrietta Lacks Memorial
Lecture Series to honor Henrietta Lacks and the global impact of HeLa cells on medicine and research. During the 2018 lectures, the University announced the naming of a new building on the medical campus for Lacks.
On October 6, 2018, Johns Hopkins University announced plans to name a research building in honor of Lacks. The announcement was made at the 9th annual Henrietta Lacks Memorial Lecture in the Turner Auditorium in East Baltimore by Johns Hopkins University President Ronald J. Daniels and Paul B. Rothman, CEO of Johns Hopkins Medicine and dean of the medical faculty of the Johns Hopkins University School of Medicine,
surrounded by several of Lacks' descendants. “Through her life and her
immortal cells, Henrietta Lacks made an immeasurable impact on science
and medicine that has touched countless lives around the world,” Daniels
said. “This building will stand as a testament to her transformative
impact on scientific discovery and the ethics that must undergird its
pursuit. We at Johns Hopkins are profoundly grateful to the Lacks family
for their partnership as we continue to learn from Mrs. Lacks’ life and
to honor her enduring legacy.” The building will adjoin the Berman
Institute of Bioethics’ Deering Hall, located at the corner of Ashland
and Rutland Avenues and "will support programs that enhance
participation and partnership with members of the community in research
that can benefit the community, as well as extend the opportunities to
further study and promote research ethics and community engagement in
research through an expansion of the Berman Institute and its work."
In popular culture
The
question of how and whether her race affected her treatment, the lack
of obtaining consent, and her relative obscurity, continues to be
controversial.
The HeLa cell line's connection to Henrietta Lacks was first
brought to popular attention in March 1976 with a pair of articles in
the Detroit Free Press and Rolling Stone written by reporter Michael Rogers. In 1998, Adam Curtis directed a BBC documentary about Henrietta Lacks called The Way of All Flesh.
NBC's Law & Order aired its own fictionalized version of Lacks's story in the 2010 episode "Immortal," which Slate referred to as "shockingly close to the true story" and the musical groups Jello Biafra and the Guantanamo School of Medicine and Yeasayer both released songs about Henrietta Lacks and her legacy.
Members of the Lacks family authored their own stories for the
first time in 2013 when Lacks's oldest son and his wife, Lawrence and
Bobbette Lacks, wrote a short digital memoir called "Hela Family
Stories: Lawrence and Bobbette" with first-hand accounts of their
memories of Henrietta Lacks while she was alive and of their own efforts
to keep the youngest children out of unsafe living environments
following their mother's death.
"HeLa," a play by Chicago playwright J. Nicole Brooks, was commissioned by Sideshow Theatre Company in 2016, with a public staged reading on July 31, 2017. The play will eventually be produced by Sideshow, at Chicago's Greenhouse Theater Center
from November 18 to December 23, 2018. The play uses Lacks' life story
as a jumping point for a larger conversation about Afrofuturism,
scientific progress, and bodily autonomy.
In the series El Ministerio del Tiempo,
the immortality of her cells in the lab is cited as the precedent for
the character Arteche's "extreme resistance to infections, to injuries,
and to cellular degeneration. In other words to aging": that his cells
are immortal.
Diagnosis is reached through spiritual means and a treatment is
prescribed, usually consisting of a herbal remedy that is considered to
have not only healing abilities but also symbolic and spiritual
significance. Traditional African medicine, with its belief that illness
is not derived from chance occurrences, but through spiritual or social
imbalance, differs greatly from modern scientific medicine,
which is technically and analytically based. In the 21st century,
modern pharmaceuticals and medical procedures remain inaccessible to
large numbers of African people due to their relatively high cost and
concentration of health facilities in urban centres.
Before the establishment of science-based medicine, traditional medicine
was the dominant medical system for millions of people in Africa but
the arrival of the Europeans was a noticeable turning point in the
history of this ancient tradition and culture. Herbal medicines in Africa are generally not adequately researched, and are weakly regulated. There is a lack of the detailed documentation of the traditional knowledge, which is generally transferred orally. Serious adverse effects can result from mis-identification or misuse of healing plants.
The geographical reach of this article is sub-saharan Africa. Though, of course neighbouring medical traditions influenced traditional African medicine.
History
Colonial era
Science has, in the past, considered methods of traditional knowledge as primitive and backward. Under colonial rule, traditional diviner-healers were outlawed because they were considered by many nations to be practitioners of witchcraft and magic,
and declared illegal by the colonial authorities, creating a war
against aspects of the indigenous culture that were seen as witchcraft.
During this time, attempts were also made to control the sale of herbal
medicines. After Mozambique
obtained independence in 1975, attempts to control traditional medicine
went as far as sending diviner-healers to re-education camps. As
colonialism and Christianity
spread through Africa, colonialists built general hospitals and
Christian missionaries built private ones, with the hopes of making
headway against widespread diseases. Little was done to investigate the
legitimacy of these practices, as many foreigners believed that the
native medical practices were pagan and superstitious and could only be suitably fixed by inheriting Western methods according to Onwuanibe.
During times of conflict, opposition has been particularly vehement as
people are more likely to call on the supernatural realm.
Consequently, doctors and health practitioners have, in most cases,
continued to shun traditional practitioners despite their contribution
to meeting the basic health needs of the population.
Modern period
Nurse at Koidu Hospital in Sierra Leone consulting with patients.
In recent years, the treatments and remedies used in traditional
African medicine have gained more appreciation from researchers in
science. Developing countries have begun to realize the high costs of
modern health care systems and the technologies that are required, thus proving Africa's dependence to it.
Due to this, interest has recently been expressed in integrating
traditional African medicine into the continent's national health care
systems.
An African healer embraced this concept by making a 48-bed hospital,
the first of its kind, in Kwa-Mhlanga, South Africa, which combines
traditional methods with homeopathy, iridology, and other Western healing methods, even including some traditional Asian medicine.
However, the highly sophisticated technology involved in modern
medicine, which is beginning to integrate into Africa's health care
system, could possibly destroy Africa's deep-seated cultural values.
Diagnostics
The diagnoses
and chosen methods of treatment in traditional African medicine rely
heavily on spiritual aspects, often based on the belief that
psycho-spiritual aspects should be addressed before medical aspects. In
African culture, it is believed that "nobody becomes sick without
sufficient reason."
Traditional practitioners look at the ultimate "who" rather than the
"what" when locating the cause and cure of an illness, and the answers
given come from the cosmological beliefs of the people.
Rather than looking to the medical or physical reasons behind an
illness, traditional healers attempt to determine the root cause
underlying it, which is believed to stem from a lack of balance between
the patient and their social environment or the spiritual world, not by
natural causes.
Natural causes are, in fact, not seen as natural at all, but
manipulations of spirits or the gods. For example, sickness is sometimes
said to be attributed to guilt by the person, family, or village for a
sin or moral infringement. The illness, therefore, would stem from the
displeasure of the gods or God, due to an infraction of universal moral
law.
According to the type of imbalance the individual is experiencing, an
appropriate healing plant will be used, which is valued for its symbolic
and spiritual significance as well as for its medicinal effect.
When a person falls ill, a traditional practitioner uses incantations to make a diagnosis. Incantations are thought to give the air of mystical and cosmic connections. Divination
is typically used if the illness is not easily identified, otherwise,
the sickness may be quickly diagnosed and given a remedy. If divination
is required, then the practitioner will advise the patient to consult a
diviner who can further give a diagnosis and cure. Contact with the
spirit world through divination often requires not only medication, but sacrifices.
Treatments
Traditional practitioners use a wide variety of treatments ranging from "magic" to biomedical methods such as fasting and dieting, herbal therapies, bathing, massage, and surgical procedures. Migraines, coughs, abscesses, and pleurisy
are often treated using the method of "bleed-cupping" after which an
herbal ointment is applied with follow-up herbal drugs. Animals are also
sometimes used to transfer the illness to afterward or for the
manufacture of medicines for zootherapy. Some cultures also rub hot
herbal ointment across the patient's eyelids to cure headaches. Malaria
is treated by both drinking and using the steam from an herbal mixture.
Fevers are often treated using a steam bath. Also, vomiting is induced,
or emetics, in an attempt to cure some diseases. For example, raw beef is soaked in the drink of an alcoholic person to induce vomiting and nausea and treat alcoholism. In the Bight of Benin, the natives have been known to use the fat of a boa constrictor to allegedly cure gout and rheumatism, and it also is thought to relieve chest pain when rubbed into the skin. Within South Africa some examples of zootherapy are the utilization of the bones of baboons as a treatment for arthritis, or the rubbing of the terpenoids of the blister beetle (Mylabris sp.) into the skin as a treatment for skin diseases. Approximately 60%-80% of the people in Africa rely on traditional remedies to treat themselves for various diseases.
A recent systematic review estimated that close to 60%
(58.2%)[4.6%-94%] of the general population in sub-Saharan Africa use
traditional and complementary medicine product. A large percentage of the people in South Africa also rely on traditional remedies to treat their animals for various diseases.
Ebola survivors in Sierra Leone have recently been reported to using
traditional and complementary medicine alone or together with
conventional medicine.
Medicinal plants
Prunus africana with stripped bark.
Africa is endowed with many plants that can be used for medicinal
purposes to which they have taken full advantage. In fact, out of the
approximated 6400 plant species used in tropical Africa, more than 4000
are used as medicinal plants.
Medicinal plants are used in the treatments of many diseases and
illnesses, the uses and effects of which are of growing interest to
Western societies. Not only are plants used and chosen for their healing
abilities, but they also often have symbolic and spiritual
significance. For example, leaves, seeds, and twigs that are white,
black and red are seen as especially symbolic or magical and possess
special properties.
Examples of some medicinal plants include:
Preparing and drying out freshly dug traditional medicines (muti)
Pygeum (Prunus africana):
Pygeum is not only used in traditional African medicine, but has
developed a following around the world, as a cure for mild-to-moderate benign prostatic hyperplasia,
claimed by its users to increase the ease of urination and reduce
inflammation and cholesterol deposits. In traditional African practice,
the bark is made into tea, whereas elsewhere in the world it is found in
powders, tinctures, and pills. Pygeum has been sold in Europe since the 1970s and is harvested in mass quantities in Cameroon and Madagascar each year.[1]
Securidaca longipedunculata: This is a tropical plant found almost everywhere across the continent with different uses in every part of Africa. In Tanzania, the dried bark and root are used as a laxative
for nervous system disorders, with one cup of the mixture being taken
daily for two weeks. In East Africa, dried leaves from the plant are
used in the treatment of wounds and sores, coughs, venereal diseases,
and snakebites. In Malawi, the leaves are also used for wounds, coughs, venereal diseases, and snakebites, as well as bilharzia,
and the dried leaves are used to cure headaches. In other parts of the
continent, parts of the plant are used to cure skin diseases, malaria,
impotence, epilepsy, and are also used as an aphrodisiac.
A study, entitled ACE Inhibitor Activity of Nutritive Plants in Kwa-Zulu Natal,
was conducted by Irene Mackraj and S. Ramesar, both of the Department
of Physiology and Physiological Chemistry; and H. Baijnath, Department
of Biological and Conservation Sciences; University of Kwa-Zulu Natal,
Durban, South Africa to examine the effectiveness of 16 plants growing
in Africa's KwaZulu-Natal region, concluding that eight plant extracts may hold value for treating high blood pressure (hypertension). The plants (known locally as muti) used by traditional healers that the team examined were:
a very leafy tropical shrub whose seeds have been used in coffee; called septic weed
Solanum nodiflorum
also known as white nightshade
Tulbaghia violacea
a bulbous plant with hairless leaves often referred to as society or wild garlic
Of the 16 plants, Amaranthus dubius, Amaranthus hybridus, Asystasia gangetica, Galinsoga parviflora, Justicia flava, Oxygonum sinuatum, Physalis viscosa, and Tulbaghia violacea
were found to have some positive effects, with the latter proving to be
the most promising with the ability to lower one's blood pressure. The unique infrageneric diversity of Aloe L. (Aloaceae/Asphodelaceae) and the broad therapeutic uses in southern Africa, suggest its cultural significance in the subcontinent. Palms are very commonly used as ritual elements, as well as an ingredient in ATM.
Some people in Grahamstown, South Africa use traditional plants and weeds as an alternative.
Cannabis sativa (intsango). The fresh leaves are made into a decoction that is taken three times a day to treat asthma,
it is also used as steam. In other parts of South Africa it is used to
cure bronchitis, headaches, labour pains and hypertension.
Cannabis Sativa plant
Carduus tenuiflorus (uMhlakavuthwa). The plant is used to
extricate poison or diseases from a sick person. It is believed the
plant sucks out the cause of the illness in itself.
Carduus tenuiflorus plant
Datura stramonium (uQhwangu-qhwangu). Fresh leaves fare used as a bandage that soothes pain and swelling. It's also used as an antiseptic after circumcision.
With the latter, the plant is only used once, it should not be used
repetitively as it can be harmful due to its potency. The fresh leaves
are also applied on boils twice a day.
Datura stramonium plant
Emex australis (inkunzane). This root is used on infants
suffering from restlessness or constipation. It is used as a root
decoction. Adults also use the decoction to treat constipation.
Emex australis plant
Galenia secunda. It is used to treat kidney pains in adults.
The root is mixed with the roots of emex australis (inkunzane). Two
teaspoons of the decoction are taken twice a day. It is also
administered to babies with colic using two drops a day.
Lantana camara (iqunule). It is used to treat back/ abdominal
pains. The roots are boiled in water and drunk as tea twice a day. Also,
it is used to treat gonococcal infection and urinary problems caused by
sexual intercourse.
Lantana camara plant
Opuntia ficus-indica (itolofiya). It is used to treat sores
between toes and the fingers, these sores are caused by igazi elimdaka
(dirty blood). These toes tend to become swollen and ooze pus. The fresh
leaf is baked in an open fire, the inner jelly is then used to apply on
the sores.
Rumex sagittatus (ibhathatha. The root infusion is put in cold
water and used as a body wash. It is used to cleanse the body of
misfortunes and evil.
Rumex sagittatus plant
Schinus molle (ipepile). The leaf decoction is taken orally to
treat fever and influenza. The leaves are added to boiling water and
the steam used to treat fever.
Schinus molle plant
Anredera cordifolia (idlula). The plants' leaves are crushed
and applied on swollen feet whose cause is attributed to poor blood
circulation. It is also used to treat kidney or liver problems. The
leaves' sap is then used to treat the rash that is caused by one's
contact with dirty water.
Anredera cordifolia leaves
Araucaria bidwillii (indiyandyiya). This is used to treat amenorrhea
caused by congenital problems, tuberculosis and malnutrition. The bark
is grated and one tablespoon of the remains is mixed with 750ml of cold
water. The mixture is taken orally once a day.
Araujia sericifera (iquwa). It is used to treat amafufunyana,
amafufunyana is described is described by Ngubane as an extreme form of
depression coupled with psychotic symptoms such as delusions, hysteria,
violent outburst and suicide ideations. The roots are mixed with other
medications to treat amafufunyana.
Argemone mexicana (ikhakhakhakha). This root decoction is
mixed with the roots of the rubus pinnatus (iqunube). It is administered
through the use of an enema to cure kidney pain. The mixture should be
used immediately as if left to stand for long it becomes harmful.
Bidens pilosa (umhlabangubo). It is used to treat
infertility in women. The roots are cleaned, boiled in
water then taken orally. Also, it is used to wash one's body after the
leaves have been soaked overnight in the bathing water. Thus bathing
water is believed to protect one from evil spirits (imoya emdaka).
A traditional medicine from the tropical Olon tree, and another species of genus Zanthoxylum, was found to have synergistic compounds that kill both mosquitoes and their plasmodium parasites.
Spirituality
Famous
Bedik diviner outside Iwol, southeast Senegal (West Africa). He
predicted outcomes by examining the color of the organs of sacrificed
chickens.
Some healers may employ the use of charms, incantations, and the casting of spells in their treatments. The dualistic
nature of traditional African medicine between the body and soul,
matter, and spirit and their interactions with one another are also seen
as a form of magic. Richard Onwuanibe gives one form of magic the name
"Extra-Sensory-Trojection." This is the belief among the Ibos of Nigeria
that medicine men can implant something into a person from a distance
to inflict sickness on them. This is referred to by the Ibos asegba ogwu.
To remove the malignant object, the intervention of a second medicine
man is typically required, who then removes it by making an incision in
the patient. Egba ogwu involves psychokinetic processes. Another form of magic used by these practitioners, which is more widely known, is sympathetic magic,
in which a model is made of the victim. Actions performed on the model
are transferred to the victim, in a manner similar to the familiar voodoo doll.
"In cases where spirits of deceased relatives trouble the living and
cause illness, medicine men prescribe remedies, often in the form of
propitiatory sacrifice, in order to put them to rest so that they will
no longer trouble the living, especially children."
Using charms and amulets to cure diseases and illnesses is an uncertain
and clouded practice that requires more scientific investigation.
The Kalahari Desert (shown in red) and the surrounding Kalahari Basin (in orange).
In African cultures, the act of healing is considered a religious
act. Therefore, the healing process often attempts to appeal to God
because it is ultimately God who can not only inflict sickness, but
provide a cure. Africans have a religious world view which makes them
aware of the feasibility of divine or spirit intervention in healing
with many healers referring to the supreme god as the source of their
medical power. For example, the !Kung people of the Kalahari Desert
believe that the great God Hishe created all things and, therefore,
controls all sickness and death. Hishe, however, bestows mystical powers
for curing sickness on certain men. Hishe presents himself to these
medicine men in dreams and hallucinations, giving them curative power.
Because this god is generous enough to give this power to the medicine
men, they are expected to practice healing freely. The !Kung medicine
men effect a cure by performing a tribal dance.
Loma Marshall, who took expeditions to South West Africa with her
family to study the !Kung people, writing two books on their findings,
describes the ceremonial curing dance as follows:
At the dances not only may the sick be cured, but pending evil and
misfortune averted. The !Kung believe that the great god may send Gauwa or the gauwas
at any time with ill for someone and that these beings may be lurking
awaiting their chance to inflict it. The medicine men in the dances
combat them, drive them away, and protect the people.
Usually there are several medicine men performing at the same time. To
cure they go into trance, which varies in depth as the ceremony
proceeds... When a man begins, he leaves the line of dancing men, and
still singing, leans over the person he is going to cure, going
eventually to every person present, even the infants. He places one hand
on the person's chest, one on their back, and flutters his hands. The
!Kung believe that in this way he draws the sickness, real or potential,
out of the person through his own arms into himself... Finally, the
medicine man throws up his arms to cast the sickness out, hurling it
into the darkness back to Gauwa or the gauwasi, who are there beyond the firelight, with a harp, yelping cry of "Kai Kai Kai."
Loma Marshall does not give any information as to whether or not the
dance is successful in curing the patient but says that it purges the
people's emotions for their "support and solace and hope."
Many traditional medicinal practitioners are people without formal
education, who have rather received knowledge of medicinal plants and
their effects on the human body from their forebears. They have a deep and personal involvement in the healing process and protect the therapeutic knowledge by keeping it a secret.
Successful Cesarean section performed by indigenous healers in Kahura, Uganda. As observed by R. W. Felkin in 1879.
In a manner similar to orthodox medicinal practice, the practitioners of traditional medicine specialize in particular areas of their profession. Some, such as the inyangas of Swaziland are experts in herbalism, whilst others, such as the South African sangomas, are experts in spiritual healing as diviners,
and others specialize in a combination of both forms of practice. There
are also traditional bone setters and birth attendants. Herbalists are becoming more and more popular in Africa with an emerging herb trading market in Durban that is said to attract between 700,000 and 900,000 traders per year from South Africa, Zimbabwe, and Mozambique. Smaller trade markets exist in virtually every community.[1]
Their knowledge of herbs has been invaluable in African communities and
they were the only ones who could gather them in most societies. Midwives
also make extensive use of indigenous plants to aid childbirth. African
healers commonly "describe and explain illness in terms of social
interaction and act on the belief that religion permeates every aspect
of human existence."
Payments
Traditional
healers, like any other profession, are rewarded for their services. In
African societies, the payment for a treatment depends on its efficacy.
They do not request payment until after the treatment is given. This is
another reason many prefer traditional healers to western doctors who
require payment before the patient has assessed the effectiveness of the
treatment.
The payment methods have changed over time, with many practitioners now
asking for monetary payment, especially in urban settings, rather than
their receiving good in exchange, as happened formerly.
There are also a growing number of fraudulent practitioners who only interested in making money, especially in urban areas.
Learning the trade
Some
healers learn the trade through personal experience while being treated
as a patient who decide to become healers upon recovery. Others become
traditional practitioners through a "spiritual calling" and, therefore,
their diagnoses and treatments are decided through the supernatural. In some cultures, a sign of calling can come from mental disarrangement said to be caused by agwu Nshi,
the spirit of divining, through which the healer gains inspiration.
Through this training, psychological stability is eventually attained.
Another route is receive the knowledge and skills passed down
informally from a close family member such as a father or uncle, or even
a mother or aunt in the case of midwives. Apprenticeship
to an established practitioner, who formally teaches the trade over a
long period of time and is paid for their tutoring, is another route to
becoming a healer.
The training is complex, depending on the kind of medical practice that
the aspiring practitioner wants to be a part of. Once the trainee is
officially initiated as a healer, they are, in some societies,
considered to be half-man and half spirit, possessing the power to
mediate between the human and supernatural world to invoke spiritual
power in their healing processes.
Importance
In
Africa, the importance of traditional healers and remedies made from
indigenous plants play a crucial role in the health of millions.
According to the International Development Research Centre (IDRC), one estimate puts the number of Africans who routinely use these services for primary health care as high as 85% in Sub-Saharan Africa.
The relative ratios of traditional practitioners and university trained
doctors in relation to the whole population in African countries
showcases this importance. For example, in Ghana,
in Kwahu district, for every traditional practitioner there are 224
people, against one university trained doctor for nearly 21,000. In Swaziland,
the same situation applies, where for every healer there are 110 people
whereas for every university trained doctor there are 10,000 people.
According to Nairobi-based specialist in biodiversity and traditional
medicine with the IDRC Francois Gasengayire, there is one healer for
every 200 people in the Southern Africa region which is a much greater
doctor-to-patient ratio than is found in North America.
Ratios of doctors (practicing modern medicine) and traditional medical practitioners to patients in east and southern Africa:
Note: References with an asterisk are in Cunningham, 1993.[6]
This table showing the ratio of traditional medical practitioner
to patient and Western practitioner to patient shows that in many parts
of Africa, practitioners trained in modern medicine are few and far
between. Because of this, healers prove to be a large and influential
group in primary health care and an integral part of the African culture
and are required for the health of its people. Without them, many
people would go untreated.
Medications and treatments that Western pharmaceutical companies
manufacture are far too costly and not available widely enough for most
Africans. Many rural African communities are not able to afford the
high price of pharmaceuticals and can not readily obtain them even if
they were affordable; therefore, healers are their only means of medical
help. According to Sekagya Yahaya Hills, who is a university-trained
dentist and a traditional healer in Uganda,
there are promising signs that some of the plant-based remedies offered
by medicine-men are not just affordable, but also effective, even in
treating AIDS. Hills read his Declaration of Traditional Healers at the 13th International Conference on AIDS and sexually transmitted infections
(STIs) in Africa, which summarized the important role of traditional
medicine, stating: "As traditional healers, we are the most trusted and
accessible health care providers in our communities. We have varied and
valuable experience in treating AIDS-related illness and accept the
great responsibility of continuing to do so."
Because this form of medicine is "the most affordable and accessible
system of health care for the majority of the African rural population,"
the African Union declared 2001 to 2010 to be the Decade for African
Traditional Medicine with the goal of making "safe, efficacious,
quality, and affordable traditional medicines available to the vast
majority of the people."
Excessive use of plants is an oecologic risk, as this may cause their extinction.
Traditional African Medicine in Relation to Women
Women
in sub-Saharan rural African communities are almost entirely
responsible for domestic work in their households. These women are often
at higher risk for disease and poverty than their male counter-parts
and have less control over their daily lives than them. A study done by
Berhane et al. (2001) found that these women defined ‘good health’ as
the ability to perform domestic duties and the state of being disease
free. Furthermore, the study found that they attributed poor health to
supernatural, evil forces, that illness is seen as a form of punishment
from spirits.
Another study, done by Mill (2001), explored the HIV/AIDS epidemic in
Ghana. Women identified HIV/AIDS with reprobate behavior, such as
“prostitution, promiscuity, and extramarital relationships”, or
traveling to areas outside the community.
These women endure arduous conditions and a traditional healer
plays an instrumental role in their daily lives. The traditional healer
provides health care to the rural communities and represents him/herself
as an honorable cultural leader and educator. An advantage of the
traditional healer in rural areas is that they are conveniently located
within the community. Modern medicine is normally not as accessible in
rural areas because it is much more costly. The socio-economic
inequality of rural communities and high costs, which limit access to
western health, is validated in the study of traditional medicine in
South Africa for HIV patients by Peltzer et al. Older rural women
particularly tend to utilize traditional healers in their communities.
Younger women and the urbanized have been found to be renouncing the use
of traditional healers.
Berhane et al. (2001) also studied a group of women in a rural
region of Ethiopia where HIV was present. These women rejected the
presence of HIV in rural villages and claimed it was an urban illness.
HIV was present in the rural communities of Ethiopia, where the study
was conducted. However, these women also claimed that their communities
did not advocate for prevention, but rather treated an illness once it
was present.
The HIV/AIDS epidemic revealed a criticism of traditional
healers’ methods in healthcare from those of modern medicine. A
particular problem is the use of certain herbal treatments for HIV/AIDS.
According to Edward Mills, herbal remedies are used as a therapy for
HIV-symptoms such as “dermatological disorders, nausea, depression,
insomnia, and weakness.” While some of these remedies have been
beneficial, the herbal treatments hypoxis and sutherlandia “may put the
patients at risk for antiretroviral treatment failure, viral resistance,
or drug toxicity.”
Hypoxia and sutherlandia put patients at risk when using antiretroviral
treatment because they interact and prevent the expression of CYP3A4
and P-glycoprotein. This results in the inhibition drug metabolism and
transport.
Peltzer et al. also found that an important issue with herbal medicines
used in traditional medicine is that when a patient decides to see a
doctor in addition to a traditional healer, they do not always mention
that he or she is taking an herbal medicine. Herbal medicines can
interact with the modern medicine prescribed by the doctor to treat HIV
and negatively impact the patient. Peltzer et al. mentions that a “IGM-1
seem to be effective in symptom improvement, but generally no
significant effect on antiviral or immunity enhancement among reviewed
herbs was seen” for the treatment of HIV. Because HIV is such a volatile
disease, it is imperative to try and boost the patient's immunity not
just relieve symptoms.
The ethical issue, as presented by modern medicine, is the
complete lack of clinical trials to test any traditional African
medicine before practicing with it on the public. According to Aceme
Nyika, modern medicine obeys Nuremberg Code, an ethic's principle
followed by doctors and scientist, to obligate humane behavior in
experimenting on the public for the good of society. Because traditional
African healers do not have to adhere to Nuremberg code, there is a
potential danger to society when healers do not practice medicine
humanely.
Traditional healers have also been under scrutiny during the
HIV/AIDS epidemic for unsanitary medical practices. Mills explains how
the “re-use of medical instruments and lack of hygienic habits such as
hand washing” have contributed to the spread of infectious diseases by
traditional healers. A study of traditional healers in Nigeria found
that 60% of the population was at risk because of the contamination
spread by tradition healers.
Sub-Saharan countries have found ways to unite modern medicine
with traditional medicine due to the urgency of the HIV/AIDS epidemic.
In South Africa, the Kundalia Foundation has provided funding to train
traditional healers on HIV/AIDS. The training included prevention, safe
sex, and knowledge about the virus.
Women experience the most fatal impacts from the HIV/AIDS
epidemic. As mentioned in Nelm and Gorski's research, when industrial
development required the labor of men from rural communities, the men
often left those communities. In African culture, the sexuality of a man
is emphasized. While men were away at the migratory labor camps, many
men would have sex with prostitutes and become infected with HIV.
Upon return, some men brought back infectious diseases such as HIV,
which they would spread to their wives, as well as to any other sexual
partner.
Furthermore, because traditional medicine does not have an early
detection method, infectious diseases are often spread unknowingly. For example, in sub-Saharan Africa 3.1 million people infected with HIV grew exponentially to 25.4 million in 2004.
Also, the patriarchal culture that defines traditional marriages in
rural areas, decrees that women are not permitted to discuss and
practice safe sex with their partners. This patriarchal traditional
South African culture, which places female sexuality under male control
results in exposing women in rural areas to a higher risk for HIV.
Relationship with modern Western medicine
Before
the establishment of science-based medicine, traditional medicine was
the dominant medical system for millions of people in Africa but the
arrival of the Europeans was a noticeable turning point in the history
of this ancient tradition and culture. Although modern scientific medicine is successful in developed countries, it doesn't have the same positive impact in many of the underdeveloped African countries.
Though Western practices can make an impact in health care practices,
in certain areas such as in the spread of various diseases, it cannot
integrate wholly into the culture and society.
This makes the traditional African practitioners a vital part of their
health care system. There are many reasons why the Western medical
system has not been as effective in Africa as it has in more developed
parts of the world. Hospitals and medical facilities are difficult for
many Africans to get to. With vast areas of land and poor road and
transportation systems, many native Africans have to travel immense
distances on foot to reach help. Once they arrive they are often
required to wait in line for up to 8 hours, especially in urban areas,
as the lack of clinics and resources cause over-crowding. Patients are
often not told the cause of their illness or much information about it
all, so they have no way to prevent or prepare for it. The technology
used is usually of poor quality, which impairs the quality of treatment.
Modern medicine can also be too expensive for the average African to
afford, making it difficult for them to receive proper care. Finally,
Modern medicine removes native Africans from the culture and tradition
and forces them into a setting that they are not comfortable with, away
from their family and traditions which are of utmost importance to them.
They do not get the proper spiritual healing that their culture seeks
and traditional ideology requires.
However, there has been more interest expressed recently in the effects of some of the medicinal plants of Africa. "The pharmaceutical industry
has come to consider traditional medicine as a source for
identification of bio-active agents that can be used in the preparation
of synthetic medicine."[6]
Pharmaceutical industries are looking into the medicinal effects of the
most commonly and widely used plants to use in drugs. It's apparent
that there are some things that can be learned from traditional African
practice. In comparing the techniques of African healers and Western
techniques, T. Adeoze Lambo, a Nigerian psychiatrist, stated in 1979,
"At about three years ago, we made an evaluation, a programme of their
work, and compared this with our own, and we discovered that actually
they were scoring almost sixty percent success in their treatment of neurosis. And we were scoring forty percent-in fact, less than forty percent."
Effectiveness
Herbal medicines in Africa are generally not adequately researched, and are weakly regulated. There is a lack of the detailed documentation of the traditional knowledge, which is generally transferred orally.
Several African medicinal plants have shown encouraging
anti-trypanosomal effects but the research is only in the concept stage. A small proportion of ethnoveterinary medicine plants in South Africa have been researched for biological activity. Research identified favorable, possible future use of the Hypoxis species, (known locally as inkomfe or African potato) in both ATM and modern medicine. South African sangomas have been long and vocal advocates of a local traditional plant called unwele or kankerbos (Sutherlandia frutescens) claiming it assists in the treatment of HIV/AIDS, cancer and tuberculosis. Sufficient preclinical data on Sutherlandia frutescens yields plausible hypotheses that may account for the reputed efficacy.
Safety
A small proportion of ethnoveterinary medicine plants in South Africa have been researched for toxic effects. The possible adverse effects of South African traditional medicines are not well documented; there has been limited research into mutagenic properties and heavy metal contamination. Serious adverse effects, even death, can result from misidentification or misuse of healing plants. For example, various aloe plants are widely used in TAM, but some varieties, such as Aloe globuligemma, are toxic and can cause death. The potential for ATMs and pharmacokinetic interactions is unknown, especially interactions between traditional treatments and pharmaceutical antiretroviral drugs for HIV/AIDS. Herbal treatments are frequently used in Africa as a primary treatment for HIV/AIDS and for HIV-related issues.
Collaboration with traditional healers has been recommended to
determine what herbal remedies are used for HIV and to educate people
supplying alternative treatments against unsafe practices. Given the demands of the local population on the use of ATMs, it has been suggested that South African medical schools should review their curriculum regarding traditional, complementary and alternate medicines.
Use of TM, using their antiviral efficiency instead of using
specific antiretroviral drugs, is especially a risk with HIV. The hope
to find a cure for Ebola or Marburg virus infections has been unsuccessful up to now.
However, this problem is also true for modern medicine.
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