Medicine and Anthropology in Twentieth Century Africa: Akan Medicine and Encounters with (Medical) Anthropology

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In twentieth century southern and eastern Africa, "traditional" medicine was the dominant healing system and often regarded as the more appropriate mode of treatment by specialists and recipients. [1] Stretching from Ethiopia, Tanzania, South Africa, and Zambia to Cameroon, Nigeria, and Ghana, indigenous African healing systems remained highly utilized by large segments of the (rural) populations surveyed. [2] These perspectives on and use of indigenous medicine were shared by parallel populations in geographically distinct places such as New Zealand, Hawaii, and the United States among persons of African ancestry. [3] Overall, indigenous healers in Ghana and elsewhere rarely translated their knowledge of medicine into social practices that emphasized the omnipresent dichotomies of "spiritual" and "natural" disease causation nor did their praxis revolve around the debates on witchcraft and the existence or denial of African "medical systems" found in medical anthropology. Akan healers in central Ghana, and I would suspect elsewhere, were unaware of and perhaps would care little about the substance of those debates. Since the 1920s, there has been a foreground of fluctuating perspectives on indigenous African medicine and therapeutics in the medical anthropology of Africa. These circular perspectives in medical anthropology have stubbornly focused on the ubiquity of "witchcraft," the natural or supernatural basis of African therapeutics, integration between biomedicine and indigenous systems of healing, but have failed to excavate African perspectives on or the relevance of these issues in the background of African societies. [4]

This essay argues the failure to locate African perspectives on therapeutic matters that may or may not be important concerns in African societies is the academic quest for "ethnographic cases" that lend themselves to issues in the field of medical anthropology rather than African knowledge and perspectives of the field (i.e., Africa). This contention is critical for it argues for a strategic distinction between two sites of knowledge production--field of medical anthropology and the "field" of Africa where fieldwork is conducted--on the larger canvas of global health issues using the local case of the Bono (Akan) therapeutic system of Ghana. Contextually, global health issues in Africa were conditioned by the failed structural adjustment and Highly Indebted Poor Countries initiatives of the 1980s and 1990s, collapsing health structures, the emergence and spread of HIV/AIDS, the global confrontation between pharmaceutical companies and African governments, and the lawsuits brought by pharmaceutical multinationals against these governments for seeking less-expensive drug alternatives. The guidelines issued by the World Health Organization (purported to ensure the sustainability and safety of the sixty billion dollars herbal medicine industry) were more than humanitarian as issues of herbal medicine--poisonings, heart problems, addition of steroids to plant medicines, poor plant quality and collection practices--continue to plague the United States, China, and Europe. The U.S. pharmaceutical industry spent $4.1 billion on drug research and development in the 1990s and consumers purchased in excess of eight billion dollars. Since 74 percent of the chemical compounds of the 119 known plant-derived drugs have the same or related use as the plants they derive, this pharmaceutical industry exploits medicinal "claims from alien cultures" in the "discovery" of new drugs. [5] As industries in the United States and Canada, the European Union, and Japan become more knowledge-intensive, and "as what constitutes national wealth shifts from the natural resource endowments toward the acquisition, manipulation, and application of knowledge," the ownership and marshaling of indigenous knowledge in and by African societies have perhaps never been so crucial. [6] In the consideration of the foregoing, and as the "Western" world extracts African medicinal knowledge to be brokered between academic and business interests and African ministries of health perpetuate colonial ideas of "traditional" medicine, the contention of this essay could not be more timely. …