TRADITIONAL HEALING PRACTICES AND SYSTEMS OF

TRADITIONAL BIRTH ATTENDANTS, BONE SETTERS AND BODY

MASSAGE THERAPISTS IN SOUTH WESTERN NIGERIA

A Traditional Birth Attendant explaining the use of different herbs to one of the research team
members in a garden at Ibeju-Lekki Local government area of Lagos State, Nigeria

Report prepared for

Nigerian Natural Medicine Development Agency (NNMDA)

by
Centre for Womens Health and Information (CEWHIN)
January 2007.
Researchers: Adebanke Akinrimisi
Atinuke Odukoya
Olufolake Sholola
Christopher S. Ereola
 Table of Contents
Introduction 4

Methodology 6

Background of Survey Sites 8

Survey report Findings from study 11

Traditional Birth Attendants 11

Bone Setters 18

Body Massage Therapists 22

Pictures

Traditional Birth Attendants 24

Natural Environment 24

Some Practitioners 28

Pictures of babies delivered by TBAs 32

Storage of finished products 35

Means of diagnosis/spiritual assistance 38

Use of medical equipment/materials 40

Traditional Bone Setters/Body Massage Therapist 43

Natural Environment 43

Some Practitioners (Bone Setters/Body Massage Therapists) 45

Types of Injuries (Bone Setters) 50

Locally Fabricated tools 55

Means of diagnosis and spiritual assistance 54

Use of medical equipment/materials 58

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 Storage of finished products 59

Herbs/medicinal plants used for traditional healing and their uses 62

Evidence of training, Association and Government support 79

Group Photographs 82

Conclusion 85

Appendices: 87

Question Guide for FGDS and Interviews 87

List of Interviewees 88

Field Workers 90

3
 Introduction

The World Health Organization (WHO) conceives traditional medicine as the sum total of all
knowledge and practices whether explicable or not, used in the diagnosis, prevention and
elimination of physical, mental imbalance and relying exclusively on practical experience
and observation passed down from generation to generation whether verbally or in writing
(Owumi, 1996). Traditional medicine is widely practiced among different ethnic groups in
Nigeria. With a population of approximately 140,000,0001 people, available reports show
that well over half of Nigerians prefer to use the services of traditional healers including
Traditional Birth Attendants (TBAs), Bone Setters, and Massage Therapists. According to
findings from the National Demographic Health Survey (NDHS) 2003, about 63% of births
and over 70% of bone related traumas are catered for outside modern hospital system.

Traditional healers have a crucial role to play in building the health system in Nigeria as well
as strengthening and supporting the national response to safe motherhood and bone setting.
The National Health Policy and Strategy (1996) aimed at achieving health for all Nigerians
recognizes the relevance of traditional medicine and seeks its collaboration in promoting
health for all, including reproductive health.

The practice of TBAs has a lot of impact on the health of the mother and child and the extent
of their activities in both rural and semi-urban context cannot be underrated. This is so
especially with the high levels of poverty prevalent in the country. Of significant connection
and implication for child delivery is the practice of massage therapists who sometimes
provide support services to TBAs especially with regards to pregnant women who have
breech babies. They are also found to provide other therapeutic services regarding different
ailments.

Furthermore, the problem of poor transportation system that is prevalent in most parts of the
country has made the use of motorbikes (otherwise known as Okada) a popular means of

1
http://www.population.gov.ng/pop_figure.pdf

4
transportation. This exposes users to road accidents resulting to minor as well as severe bone
fractures in some instances. Statistics have revealed a gradual rise in the number of people
maimed as a result of Okada rides.2

This report is based on a survey of traditional healing practices prevalent in the South
Western part of Nigeria, focusing especially on the activities of TBAs, Bone Setters and
Massage Therapists. It documents their healing methods, the materials that they use as well
as the kinds of facilities they use for their practices.

2
This position was expressed in the Editorial of the Daily Trust Newspaper of September 26, 2006.

5
 METHODOLOGY

Goal and Objectives

The survey was designed to promote a deeper understanding of the scientific basis for the
methods and practices of traditional birth attendants, bone setters and massage therapists in
three ethnic communities in South Western Nigeria

In more specific terms, the survey was designed to achieve the following:
To identify traditional healing techniques used by TBAs, Bone Setters and Massage
Therapists in the selected areas;
To identify possible areas of collaboration between modern health care providers and
traditional healers;
To promote the rights of clients of traditional healers in Nigeria;
To facilitate the evolvement of a national framework for improving the services
offered by Nigerian traditional healers.

Data Collection Instruments and Implementation

The survey was descriptive in nature. The major technique of data collection was qualitative.
The survey examined the practice of TBAs, Bone Setters and Massage Therapists in the
South Western Region of Nigeria and specifically looked at the types of medicinal plants,
herbs and animal products that traditional healers make use of in providing health care
services to their clients.

The survey was carried out among the Ijebus, the Eguns and the Egbas in Lagos and Ogun
States. The selected ethnic groups investigated in Lagos State were the Ijebus at Ibeju/Lekki
Local Government Area (LGA); the Eguns at Badagry LGA and the Ilajes/Ijaws at Ifelodun
Local Government Area. In Ogun State, the Egbas and Aworis at Abeokuta LGA were
surveyed.

The traditional healers who participated in the survey were selected using the snowball
sampling method. Health Educators and development workers who were known to be very

6
conversant with the communities visited, provided support to the investigators in mobilizing
the traditional healers that were surveyed.

Data on type and quality of services provided by the various traditional healers were
collected through in-depth interviews and focus group discussions (FGDs). In all thirty five
(35) interviews and four (4) FGDs were conducted. The choice of method used was based on
the available number of participants. FGDs were held with TBAs at Ibeju Lekki, Badagry
and Abeokuta while In-depth Interviews were conducted among Traditional Birth
Attendants, Bone Setters and Massage Therapists at Ibeju Lekki, Badagry, Abeokuta and
Ifelodun Local Government Areas.

The interviews and FGDs covered issues relating to the types of complications that TBAs
handle and at which point they make referrals to modern medical facilities. The interviews
also covered the types of herbs, medicinal plants, animal products and equipments that are
used during the course of their work. On site visits were also paid to traditional healing
homes in order to have a fair appreciation of the conditions under which traditional health
care services are provided.

7
 Background Information on Survey Sites

Ibeju/Lekki Local Government Area of Lagos State (Ibeju/Lekki LGA)

According to information obtained from the Ibeju/Lekki LGA Secretariat in 2006, the
communities that make up the current Ibeju-Lekki LGA were founded about 500 years ago
when the first settlers migrated from Ayepe, a town in Ijebuland. The reason for the
migration was traced to severe drought that ravaged Ijebuland and forced many to flee in
search of arable land and water.

Ibeju/Lekki LGA was initially created in 1979 during the 2nd Republic under the then Lagos
State Governor, Alhaji Lateef Jakande. It was scrapped when the military took over power in
December 1983. The Local government was re-created out of Epe Local Government by the
Babangida administration in May 1989. The LGA is made of two definable districts of Ibeju
and Lekki with headquarters at Akodo. It has its boundary to the North by the Lagos Lagoon
and the South by the Atlantic Ocean. The LGA also shares common boundaries with Epe
Local Government on the East and Eti-osa Local Government on the West.

With an estimated population of approximately 38,0023, it is the least populated and poorest
income generating LGA in Lagos State. The total land mass area of the Local Government is
653.00sq.km while the water area is 10.00sq.km. The total land size is equivalent of 1/3 rd of
total land mass of Lagos State. The LGA is on water terrain which has made the area difficult
to traverse by land. The people of the LGA are predominantly Yorubas (Ijebus) with the
Ijebu dialect widely spoken as a medium of communication. The people are believed to have
migrated from Ijebu-land in Ogun State and Ile-Ife in Oyo State. The people of Ibeju-Lekki
lead a simple lifestyle and live mainly in houses made of bamboo and palm fronds arranged
in several hamlets. There are few interspersed cement houses. They are mostly fishermen and
petty traders.

3
This figure is according to projections by the Lagos State Government 1999 2002. The 1991 population
count gave a total of 24,937, 12,426 being males and 12,511 being females.

8
Abeokuta Local Government Area
Abeokuta is the capital city of Ogun State in Southwest Nigeria. It borders Lagos State to the
South, Oyo and Osun States to the North, Ondo State to the East and the republic of Benin to
the West. The total population of Ogun State according to the 2006 Census is 3,728,0984. As
at 2002, Abeokuta proper had an estimated population of about 230,000, while the figure for
the city and outlying environs was approximately 500,000 individuals. The city lies below
the sacred Olumo rock, home to caves and shrines. Abeokuta is spread over an extensive
area, being surrounded by mud walls, 18 miles in extent. The women of Abeokua are famous
for the production of tie and dye fabrics popularly known as Adire and many of the men are
farmers.

Abeokuta (a word meaning under the rocks,), dating from 1825, owes its origin to the
incessant in-roads of the slave hunters from Dahomey and Ibadan, which compelled the
village populations scattered over the open country to take refuge in this rocky stronghold
against the common enemy. Here, they constituted themselves a free confederacy of many
distinct groups, each preserving the traditional customs, religious rites and even the very
names of their original villages. Yet this apparently incoherent aggregate held its ground
successfully against the powerful armies often sent against the place both by the king of
Dahomey from the West, and by the people of Ibadan from the North-East.

The district of Egba, of which Abeokuta is the capital, has an estimated area of 3000 m. It is
officially known as the Abeokuta province of the Southern Nigeria protectorate. It contains
luxuriant forests of palm trees, which constitute the chief wealth of the people. Cotton is
indigenous and used to be grown for export. The ultimate traditional ruler of Abeokuta
(chosen from among the members of the two recognized reigning families) is called the
Alake, a word meaning Lord of Ake, Ake being the name of the principal quarter of
Abeokuta, after the ancient capital of the Egbas. Notable townships in Abeokuta are Ibara,
Orile Imo, Igbein, Ita Eko, Ake, Ijemo, Itoku, Lafenwa, Oke Jeeun. This survey was carried
out at Kenta and Ago Egun, Isabo in the Abeokuta South Local Government Area of Ogun
State.

4
http://www.population.gov.ng/pop_figure.pdf

9
Badagry LGA
Badagry is a coastal town in South West Nigeria, lying between Lagos and the border with
Benin. It is bounded in the South by the Atlantic Ocean. Founded in the early 15th Century
on a lagoon off the Gulf of Guinea, its protected harbour led to the town becoming a key port
in the export of slaves to the Americas. From the 1840s, following the suppression of the
slave trade, Badagry declined significantly, but became a major site of Christian mission. In
1863, the town was annexed by the United Kingdom and incorporated into the Lagos colony.
In 1901, it became a part of Nigeria. Badagry subsists largely on fishing and agriculture, and
maintains a small museum of slavery. Badagry town houses the first storey building in
Nigeria, built in 1845 and still standing on its original site.

Badagry's original name was Gbagle, a contraction of the word Ogbaglee, meaning in Ogu
(not Egun as commonly mis-pronounced and mis-spelt) "a farmland near the swamp". The
history of Badagry has a fascinating tradition of Kingship (Wheno-Aholu) and local
administration. The ancient town of Badagry is divided into eight quarters namely: Jegba,
Ahoriko, Awhanjigoh, Boekoh, Wharakoh, Pesuka and Ganho and its adjoining villages on
both the mainland and island, have for centuries recognized the Wheno Aholu Akran of
Badagry, of which there have been seventeen from the earliest times to the present Akran,
Menu Toyi I crowned in 19775.

Ifelodun Local Council Development Area6

Ifelodun Local Government is located in the heart of Lagos. It is bounded by Coker- Aguda
local government and badagry expressway in the North, by Apapa/Iganmu Local government
on the East, Amuwo on the West and Ajeromi on the South. The local government can be
tagged a mini-Nigeria due to the mixture of people of almost every ethic group in Nigeria,
living together in peace and harmony. The history of what is today known as Ifelodun local
government dates back to the early 18th Century. The main occupation of the people is
trading. This is evident in the number of markets and other trading centres within and around
the local government.

5
http://www.ngex.com/nigeria/places/states/lagos.htm
6
Excerpts from a write up by the Information Officer of Ifelodun Local Government Area of Lagos State.

10
 FINDINGS FROM SURVEY

Introduction
Although all sessions held with the various groups of traditional healers turned out to be
highly educative and successful, they were not free from initial fears and suspicion. This was
so, despite the background information that they received during the planning stages of the
activity and at the beginning of each session. As a result of past experiences of being
involved in similar activities without benefits to their groups, the traditional healers were
very reluctant about sharing knowledge of their practices with the research team. They
claimed that instances abound in the past, when individuals had capitalized on their naivety
and acquired wealth and other favours by merely serving as intermediaries between them and
government agencies. Despite this bias, the survey results are considered reliable, as the
survey yielded comparable results from similar groups at different locations.

A. Traditional Birth Attendants

Most of the TBAs were trained by their parents. In addition to this, they have had opportunity
of attending short training courses on different aspects of obstetric care organised either by
the Federal or State Ministries of Health. Some of such trainings were organized by
UNICEF, WHO or other private Non Governmental Organisations. Experiences gained from
such trainings have greatly influenced their practice. Visits to some of the clinics of the
traditional healers revealed that that some of them work with trained doctors and nurses.
They have special arrangements with such trained personnel on referrals and consultations.
Such instances were found at Badagry and Suru Alaba.

Types of Cases seen by TBAs

All sessions held with the TBAs highlighted the fact that they receive and handle various
types of obstetric cases and complications. They alluded to the fact that their methods of
healing were more relevant and responsive to the peculiar situation of women in the
communities. According to them, some of the complications that pregnant women have
cannot be treated by relying solely on knowledge of modern medicine. Traditional healing

11
methods were considered highly critical because some of such complications are due to
witchcraft or other forms of spiritual power(s). Allusions to efficacy of their methods could
not be easily verified within the scope of the survey. Some of the TBAs made reference to
situations whereby they had assisted with taking deliveries whose term ranged between two
and seven years. Such pregnancies, they claimed have lasted so long because of certain evil
powers that were bent on punishing such pregnant women.

Some of the experiences shared by the TBAs were as follows:

First Time Mothers
The TBAs recognized the fact that first pregnancies often require extra care. They reported
that they do encourage such mothers and give them herbs that they apply to their private part
to make dilation of the cervix easy. Some of the TBAs said that they advise the women to
take a lot of Cochorous olitorus (Ewedu soup) on a regular basis at least three weeks prior to
their expected date of delivery.

Threatened Abortion and Miscarriages

To treat this, the TBAs at Ibeju Lekki have different methods. Some said that they boil leaves
such as Alternanthera repens (Sessile joyweed) (Dagunro) and Coconut tree leaves, Cocos
nucifera (Ewe Agbon) and give the patient to drink. Others reported that they use Lannea
barteri (Ewe Olosan), the back of its tree and small red pepper (Capsicum spp.) (Arajos).
These are pounded in a mortar and put in a bottle with any hot drink and given to the patient
to drink.

Breach or Transverse Baby

The TBAs condemned the use of surgery to deliver breach babies. They explained that with
the use of appropriate herbs, surgery can be avoided. In treating a woman in this condition,
herbs such as Peperomia pellucida (Ewe Rinrin), Maboyunku and Fertility tree (Newbouldia
laevis) (Epo Akoko) are cooked together with palm tree maggots and given to the woman to
eat three consecutive times. According to them, after the consumption the baby is bound to
change its position and the mother can have a normal delivery.

12
Placenta Praevia
Some of the TBAs said they give seven days treatment to address this and the placenta
thereafter moves to its proper position. Seven seeds of alligator pepper are cooked with
grinded breadfruit, Artocarpus integrifolia (Ewe jasoke) and cat fish (Eja Aro). Other herbs
such as Xylopia aethiopica (Eru) or Uvaria picta (Alupaida) are added depending on the sex
of the child being expected. Interestingly, a TBA at Suru Alaba said he would usually use his
hands to manoeuvre the placenta back to its proper position, but if it is a complicated case, he
would refer the patient.

Retained Placenta
According to some of the TBAs, women with retained placenta are made to blow air into a
bottle and this helps the process of expelling the placenta. Others said that they grind seeds of
Alligator pepper (16), Aframonium melegueta (Atare) and mix the powder with sand
collected in a special way. Water is thereafter added to the mixture and given to the woman
to drink. Collection of the sand involves the pronouncement of incantations.
Some say that they give the patient lime juice to drink, while some said they grind the shell
of eggs with alligator pepper and give to the patient.

Prolonged Labour
According to the TBAs, labour experiences are often considered to be prolonged when it is
not the babys time to be born. When a woman is undergoing labour and her cervix does not
dilate, the TBAs said they have different types of herbs and treatment for addressing such
cases. They can give Eragrostis tenella (Ewe abiwere) or a mixture of herbs cooked together
(Aseje). They can also grind Biophytum sensitivum sp. (Ewe oniyebiye) and mix it with shea
butter (Ori) then use it to rub the womens tummy upwards.

Babies born distressed after birth are revived with a mixture of sand and water which is
sprinkled on the babys body. Another method is to soak the bark of Tricilia heudeloti (Igi

13
olomi) or Eleusine indica (Ewe gbegi) in water and sprinkle it on the babys body. The baby
is also given some of the liquid to drink.

When asked how they repair the vagina after birth in case a woman has a vaginal tear, the
TBAs said that women who delivered at their clinics hardly have vaginal tears, but if they
have, it was treated with regenerative plant, Entandrophragma utile (Ewe olusodi) and not
stitches.

Multiple Pregnancies
When asked how they detect multiple pregnancies, some of the TBAs said they use Ficus
Exasperata (Epin ile also called Ewe majemu) and a special type of kola nut that naturally
splits into four parts Obi Abata (Cola acuminata). The leaf would be grinded and rubbed on
the womans tummy and then they start inserting the pieces of kola nut in the womans
vagina one by one, the number of pieces that stuck inside the woman would indicate the
number of babies the woman would have.

High Blood Pressure

Women who have high blood pressure (HBP) in pregnancy are given extracts from
Gossypium hirsutum (Ewe Efe owu) to drink. This helps the pregnant woman to pass a lot of
urine and this leads to a positive alteration of the level of the blood pressure. They also treat
such women with herbal drink made from a plant called Touch and Die' - Biophytum
sensitivum var (Ewe jelenumenu). On the question of how they diagnose HBP, some of the
TBAs said the eyes of such women usually look very pale and that such women often
complain of being weak. Although some of the TBAs said that they often refer patients with
swollen feet to the next level of care, some say that they have the proper treatment for
addressing such symptoms and therefore, do not have to refer such women.

Post Partum Hemorrhage

In treating this, Manihot utilisima (dried cassava leaves) that dropped off a cassava plant are
picked and burnt with other herbs and given to the patient to eat either added to food or

14
licked on their palms. They also use a herb called Cissampelos pereira (Gbejedi). According
to them, these stops bleeding instantly.

Infertility
In treating infertility, the TBAs had similar treatment methods. They investigate whether the
reason for infertility is spiritually inclined and then check which of the couple has a problem.
Leaves such as Alternanthera repens (Dagunro) and Indian Spinach (Amunututu) are said to
be useful in the treatment of infertility. Some of them also said that they use bush rat to make
a special herbal concoction for the couple to eat.

Equipment and other Working Tools used in Service Delivery

The most widely used modern tool among TBAs is the fetoscope. Even this, some said they
do not use as they claim to have alternative and more efficient ways of monitoring a babys
heart beat. A TBA at Ibeju-Lekki said he uses a herb called Earth okra, Curcuma domestica
(Ila Ile) to rub a pregnant womans tummy and thereafter put his ear on the tummy.
According to him, the sound reception is usually very clear.

Only a few of them make use of the sphygmomanometer. A few of the TBAs have labour
beds, while most of them use mats in their clinics.

Challenges or problems that TBAs have

Unsettled bills
One big challenge raised across all areas visited was the fact that despite the enormous work
that they do, they were often poorly remunerated. This they claimed make their work
difficult. Although, the fees that they charge were normally about 50% to 75% less than what
the government and private hospitals normally charge (especially for normal deliveries), their
patients often do not settle their fees at all or they only settled a part of it. Some of the
patients, they said make promises that they do not keep or resort to begging for debt
forgiveness, in which case, they often found it difficult to insist on payment. Some of the
TBAs shared experiences of instances when babies were abandoned at their clinics and the

15
hardship they experienced in trying to locate the appropriate authorities to whom such cases
could be reported.

Police harassment on the death of patients

Another challenge raised relates to the issue of death of patients in their clinics. They shared
experiences of police harassment in situations where families of deceased patients got them
arrested. Families also sometimes abandoned corpses at their clinics.

Hostile attitude of government health staff

Some Traditional Healers reported that government health care providers do not often respect
them. The TBAs recalled experiences of shabby treatment from government staff when they
refer patients to their Centres.

Areas where TBA s require support?

Provision of Traditional General Hospital
The TBAs said they would appreciate it if government set up Traditional General Hospitals
where highly experienced traditional health practitioners could practice so that referrals of
complicated cases could be made to such hospitals by less experienced practitioners.

Right to issue Birth and Death Certificates/Record Keeping

They also raised the need to be given support in the area of record keeping. They called for
the right to issue birth and death certificates for proper documentation.

Provision of Medical Equipment and the technical knowledge

Some of the TBAs said they were often unable to monitor the blood pressure of their patients
properly as they do not have sphygmomanometer. They made a request for government to
support their practice with necessary basic equipment.

16
Charges and Services
Charges for different services offered by TBAs
Most of the TBAs said that they charge two thousand five hundred Naira (N2,500) for
normal delivery. Some said they only demand items such as drinks, biscuits or other edible
items. Some say that they demand fees but when the patients cannot pay they often have no
choice than to receive gifts as payment for their services. According to them, on many
occasions, such gifts are wall clocks which usually cost like N250.00 (approx. 2 dollars). One
of the TBAs at Badagry said that she now has so many wall clocks in her house that she had
warned many of her clients never to present her with wall clocks.

Maternity Home
Most of the TBAs visited operate from their private residential homes. They often set aside
one or two rooms for their practice. Only a few of them have their clinics clearly separated
from their homes. This ensures that they can be reached by their patients almost at any time.
Some of the TBAs have modern labour beds while most of them use mats.

Assessment of knowledge of how to Prevent Contracting and Transmitting HIV

The TBAs said they protect themselves and their patients against HIV infection through the
use of gloves whenever they come in contact with blood. They informed the research team
that they use fresh blade for each patient. Interestingly, some of the TBAs said that with the
spiritual powers that they possess, they were often able to discern those patients that were
capable of posing a threat to their health. They said that prior to the arrival of a patient they
do receive messages from their gods on whether or not to treat such a patient. This also
relates to situation of patients whose problem were rooted in spiritual warfare, in which case
they would be informed by their gods not to treat such a patient. Some also said that they
possess powers that make it impossible for them to contract any disease even if a patient was
HIV positive.

17
B. Bone Setters
Majority of the Bone Setters interviewed claimed that it was a profession that past
generations of their families had been engaged in. As such, they acquired the skills for bone
setting as they grew up. Most of the Bone Setters reported that they were unable to separate
spirituality from their practice, noting that in order to have a successful practice, they must
rely on some spiritual powers. They believed that the healing of their patients injuries was
done by their gods and that they only served as media. To buttress this point, some of them
showed us the symbols of their gods and how they worshiped them. They believed that they
are more effective than modern health practitioners. They expressed the believe that their
gods were able to heal all kinds of bone injuries so far the patient got to them in good time.
They shared instances when they successfully treated patients with cases that had been
earmarked for amputation.

The Bone Setters interviewed at Ibeju-Lekki and Abeokuta made the point that chicken plays
an important role in the process of treating patients. They reported that when they received a
patient with a fractured limb, they would buy a chicken and break the chickens limb at a
similar point where the patients limb was fractured. The believe is that chicken do not die as
a result of broken bone as such, as the chickens limb heals, the patients limb too heals. In
treating patients with fractures of different kinds, Bone Setters also use special soaps (made
with herbs), herbal concoction and herbal drinks which often contain animal bones.

Types of Cases Seen by Bone Setters

Simple and Compound Fracture
The Bone Setters interviewed receive and treat patients with simple and compound fractures
resulting from road or domestic accidents. When asked whether they use X-rays to determine
the exact point of injury of their patients, their response was that they never request patients
to take X-rays before they know what to do. For cases whereby patients are bleeding
profusely as at the time they were brought in, the Bone Setters said that they use Portulaca
quadrifida (Ewe Dasa ), Eupatorium odurantun (Ewe Akintola) and Occimum gratissimum
(Efinrin) to stop bleeding.

18
Stiff Bones and Cases of Uncontrollable Movement of the limbs (Contracture)
The Bone Setters reported that often times they receive patients who ended up with stiff
bones or whose veins can no longer control their limbs after undergoing treatment at modern
hospitals. In treating stiff bone, they use balm (Adesan) made of Chasmanthera dependens
(Ato), Xylopia aetiopica (Eru), Eugenia Aromaticum, clove (Kanafuru), Ida gogo and Shea
butter (Ori) and for uncontrollable limbs, they prepare edible herbal powder (Alesan) from
Ojiji root, Cat fish, Local spice, Parkia biglosa (Iru), Capsicum spp (Ata Ijosin), Allium
sativum (Alubosa) and give to the patient to eat.

Cancer
They also claimed to be able to cure cancer patients with the use of a special concoction
(Agbo) which the patient had to drink for some period of time. A very useful plant for this
according to the Bone Setters at Abeokuta is Jateorrhiza palmata L. (Lobutu)

Cases with spiritual undertone

The patients remarked that there are instances whereby patients problems are rooted in
spiritual warfare, in which case they consult their gods to know the cause of the problem and
whether or not to treat such a patient. If it was something they could handle, they would
usually use leaves such as Acanthospermum hispidum (ewe mafowokanmi) or Milk thistle
(Ewe kilomafimise) to treat the patient. For instance, it is believed that when a plant called
Okookudu (in Ijaw Language) is mixed with native soap and used by a patient to have a bath,
all evil spells placed on a patient are cleared.

Rheumatism
The stem of a plant called Torugbesa (in Ijaw Language) is cut into small bits and soaked in
a fizzy drink (7-up or sprite) for a patient to drink. The plant could also be soaked in water in
which case it would only be used within two days after which it has to be discarded because
of its awful smell.

19
Equipment and other Working Tools used in Service Delivery
A slight difference was noted in the type of splint that are used by the Bone Setters. While
Eguns at Abeokuta (Ogun State) use modified palm front Raphia vinifera (Kere), the Ijebus
at Ibeju-Lekki use modified palm front Brachyestegia curycoma (Ako). All the Bone Setters
interviewed use bandage to wrap the splint around the injured part of the body in order to
keep the bone in place till the wound heals.

According to one of the Bone Setters at Suru Alaba, in treating serious injuries, he uses splint
(Kere) lined with herbs. This would be placed on the fire and the patient would be placed on
it. This according to him dries up the patients flowing blood. Once the patient could jump
off the splint, the belief was that such a patient would survive the injury.

Challenges or problems that Bone Setters face

The challenges raised by the Bone Setters were quite similar to those raised by the TBAs.
They complained of poor remuneration. They reported that they remain poor despite the fact
that they work so hard and contribute to human capital development. Many of their patients,
are people who cannot afford to pay for health care services. Some give them gifts such as
farm produce or drinks and this does not address their own needs. According to them,
instances abound whereby they have to use their own resources to treat patients when the
patients cannot pay. In such cases, they may not be able to perform their functions well as
they also have financial constraints.
They also complained of having poor working environment which means that they cannot
attract certain level of clients despite the fact that they considered themselves better skilled to
address all forms of problems.

Areas Where Bone Setters Require Support?

The Bone Setters expressed the wish that government can support them by providing them
with beds and mattresses for their patients, ointments for massage purposes. They also want
government to build clinics for them, but some of them remarked that they would not be able
to operate together as they posses different level of knowledge and power.

20
Charges for different services offered by Bone Setters
The Bone Setters reported that their fees are very low. Often times they are unable to charge
because they know the financial situation of the people and when they beg them that they are
unable to pay, they have no choice than to forget about their fees. However, they sometime
have to charge because it may be necessary for them to carry out some investigations.

Facilities
Most of the Bone Setters use rooms in their personal houses as clinics. Some use make-shift
sheds built with bamboo trees or wood planks. Such clinics were poorly equipped and often
dirty with poor sanitary facilities. One of the Bone Setters at Ibeju-Lekki caved out three
rooms from his house for his practice and this was assessed to be clean compared to other
places visited. Another well established Bone Setter at Suru Alaba who had been practicing
for over twenty years, had eight rooms committed to his practice.

Assessment of knowledge of how to prevent contracting and transmitting HIV/AIDS

The Bone Setters at Abeokuta made the point that they believe that HIV is real and as such
they use gloves before treating patients and they do not re-use sharp objects. They dispose
them after use. This was slightly different from what the Bone Setters at Ibeju- Lekki said.
They claimed they have herbs that enable them to know whether or not a patients blood was
infected.

21
C. Body Massage Therapists
The practice of body massage is not so common among the three ethnic groups visited. The
survey revealed that it is mostly practiced by the Ijaws and they provide support services to
TBAs and Bone Setters. Their services are often used when women have babies that lie in the
wrong position or transverse lie as well as for people with arthritis or stiff bones.

The body massage therapist interviewed reported that spirituality cannot be separated from
his practice, noting that in order to have a successful practice he must rely on the backing of
his gods. He believes that his father transferred some powers to him through his palms and as
such, he was the only one in the family that had taken up the job and successfully too. To
buttress this point, he claimed that he had recorded only one death since the inception of his
practice, this he attributed to the fact that as soon as he touched a patient he will know
whether the patient will survive or not and that as soon as he realizes the patient will not live,
he does not attend to such a patient. The only death he claimed he recorded at his clinic was
of a patient whose family members he already warned that he had no chance of survival no
matter where he was taken to.

He believes that because of the spiritual powers transferred to him by his father, he can have
no difficulty in the work that he is doing. Although he is a Massage Therapist, he specializes
in bone setting.

Kinds of Cases that Massage Therapists see

Placenta Praevia
The massage therapists interviewed at Ifelodun LGA informed the research team that he
mostly received cases of women with placenta praevia. To this, he says he does not require
any X-ray or scan to be done, he depended on his hands. All he would do was to maneuver
the placenta back to the proper position with his hands and in complex cases, he would
require Medical Doctors assistance. The massage therapist also assists with womb fixing
making use of herbs and massaging.

22
Equipment and other working tools used in providing services
Massage Therapist make use of their hands in giving body massage. They use Shea butter
(Ori) as a lubricating balm during massage.

Challenges or problems that Massage Therapists face

The challenges raised by the massage therapist were quite similar to those raised by the Bone
Setters and the TBAs. The complaint was about poor remuneration. Many of the patients
seen by therapists are people who cannot afford to pay for health care services. Some give
gifts or drinks which are often not sufficient to meet the therapists own economic needs. This
was said to be responsible for the poor environment in which they operate. They cannot
afford to renovate their buildings which often times were inherited from their late parents.

Areas where Massage Therapists require support?

The call was made for government to support them by refurbishing their clinics and also by
providing beds and mattresses for their patients.

Facilities
The Massage Therapist interviewed at Ifelodun LGA has a building where he administers
treatment. The building is made up of eight (8) rooms. He admits patients when the need
arises. He uses the building for his body massage and bone setting job. He has a couple of
beds in the house but the state of the house is very poor and not considered hygienic for
providing healthcare services.

Assessment of knowledge of how to prevent contracting and transmitting HIV/AIDS

The Massage Therapist made the point that he knew that AIDS was real and as such he
makes use of hand gloves before treating patients.

23
 Natural Environment Where Traditional Birth Attendants Practice

Typical Traditional Birth Attendant clinic at Ibeju Lekki

Inside the hut where a traditional birth attendant uses for his delivery at ibeju lekki

24
 Side view of TBAs hut at ibeju Lekki

Front View of olumo rock, a serene environment for the traditional practitioners and a great
tourism centre. The town Abeokuta was named after the Olumo rock.

25
Outside view of a traditional Birth clinic at Abeokuta

Inside Jagilegbo traditional Birth clinic at Abeokuta

26
Dual shift delivery room used by TBA at Suru Alaba used both for residential and delivery
purposes

Signpost of spiritual and maternity home at Badagry

27
 Outside view of a spiritual home at Badagry

A typical ward in the Emiloju traditional/spiritual Home in Badagry

28
 Some Practitioners (Traditional Birth Attendants)

Cross section of Traditional birth attendants at Ibeju Lekki discussing with field officers

Traditional/Spiritual Birth Attendant in her delivery room at Badagry local Government

29
 A traditional Birth Attendant showing the use of Asofeyese in Traditional Delivery

Traditional Birth Attendants at Kenta, Abeokuta explaining use of herbs to field officers

30
 Traditional Birth Attendants at Abeokuta during focus group discussion

Field officers with traditional birth attendant, twins delivered by the TBA and their mother

31
A traditional birth Attendant in his delivery room at Badagry Local government

32
Pictures of Some Babies Delivered by Traditional Birth Attendants

Set of triplets delivered by Traditional Birth Attendant at Badagry

Set of twins delivered by Traditional Birth Attendant at Suru Alaba

33
 Set of twins delivered by traditional birth attendant at Badagry

Traditional Birth Attendant who delivered herself and her baby at Abeokuta

34
 Storage of Finished Products

A container containing a local concoction for turning a baby (Ayi Omo) into the right
direction

Storage for ante natal drugs used by patients at Badagry

35
Containers containing various types of concoctions used by TBA in treating his patients

Storage of a concoction mixed for pregnant women

36
Display of containers used to store various types of dry concoctions

Storage containers for black soap and other concoctions

37
 Means of Diagnosis/Spiritual Assistance

The use of cowries by Traditional Birth Attendants for consulting the spiritual

Local hatched eggs used to aid difficult labour

38
Altarat Emiloju Spiritual and maternity home where prayers are offered for pregnant women
during ante natal clinic and when spiritual assistance is required during delivery.

39
 Use of Medical Equipment/Materials

Use of gloves and modern facilities by a trained Traditional birth attendant

Sterilizer used by a traditional Birth Attendant from Badagry, an evidence of strict hygiene

40
Lab coat and fetoscope used by Traditional Birth Attendant in Spiritual home in Badagry

Baby weighing scale used by TBA in Badagry

41
Local Delivery couch used by traditional birth attendant at Ibeju Lekki being spread in the
sun after usage

42
Natural Environment where traditional Bone Setters and Massage therapists practice

Signpost of herbal healing clinic at Suru Alaba, Ifelodun Local governent

A typical Traditional bone setter ward at Suru Alaba

43
Typical traditional Bone Setter Clinic at Ibeju Lekki

Traditional bonesetter in his office at Ibeju Lekki

44
Some Practitioners (Traditional Bone Setters and Body Massagers)

Traditional Bone Setters with ambulating patients in Abeokuta

Traditional Bonesetters during interview in Ibeju Lekki, Lagos state

45
 Traditional bone setters with a patient in Suru Alaba, Lagos State
A

Body Massager/Traditional Bone Setter explaining the mode of his work to field officers at
Suru Alaba

46
 A

Traditional Birth Attendant (Woman) that uses the services of the body massager for her
pregnant patients and Traditional Massage Therapist explaining the use of Ogologolo in
Body massaging to Field officer

Traditional Bone setters at Ago Egun, Abeokuta discussing with field officers

47
Field officers discussing with a massage therapist in his herbal preparation kitchen at
Suru Alaba, Lagos state

Field workers interviewing a traditional bone setter in Suru Alaba, Lagos

48
Field officers interviewing a bone setter in Suru Alaba, Ifelodun local government, Lagos
State.

49
 Types of Injuries Seen By Traditional Bone Setters

A Boy being treated at a traditional bone setters home/clinic at Abeokuta

The Boys deformed leg which is believed to be cancer of the bone

50
Traditional Bone Setter listening to a recuperating fractured pelvic patient in Abeokuta

A fractured patient with fresh wound recuperating at Abeokuta

51
A Traditional Bone Setter with patient after bandaging a Fractured Femur

Ambulating Patient at Ajegunle, Lagos State

52
Bone setter attending to one of his patients at Ajegunle, Lagos State

Recovered bone fragment from a crush injury

53
 Means of diagnosis/Spiritual Assistance

A Traditional Bone Setter in Abeokuta showing Ijan (a household god) as a vital tool
in bone setting

A Traditional Bone Setter demonstrating the use of Ijan by the Eguns in

Bone Setting

54
 Locally Fabricated Tools

A typical ethno equipment (Back rest) used by traditional bone setter

Local Splint (Akere) used by bonesetters at Abeokuta

55
Local Splint made from Palm fronds used by bonesetter at Ifelodun

Bundle of local palm fronds used by bonesetter at Suru Alaba

56
Palm fronds (Ako) and bandages used by bonesetter at Badagry

57
 Use of Medical Equipment/Materials

Display of elastic bandage used by traditional bone setters at Suru Alaba

The use of modern bandages and hand gloves embraced by traditional bone setter/massage
therapist

58
 Storage of Finished Products

A coconut shell containing local balm for massage used by Traditional Bone Setter at Suru
Alaba

A local balm used for bone setting and massaging at Ibeju Lekki

59
Pots and containers used for preparing concoctions by bone setter/body massager at Suru
Alaba

Decoction for bone setting containing Xylopia aetiopica stored in an earthen ware and kept
outside

60
A locally fabricated tool, Akere used to seive concoctions used by Trabitional Bone
Setter/Massage Therapist ar Suru Alaba

61
 HERBS/MEDICINAL PLANTS USED FOR TRADITIONAL HEALING 7

English: Basil
Yoruba: Efirin Nla
Hausa: Dal Doya
Igbo: Nchu Anwu
Botanical: Ocimum gratissimum L.

Use: Decoction of entire plant is used in the

treatment of parasitosis, diarrhea, dysentery,
epitaxis, convulsions, fever and dermatosis.

English: Lemon Grass

Yoruba: Kooko Oba
Hausa: Isauri
Igbo: Achara Ehi
Botanical: Cymbopogon citratus

Use: The leaves are used as diuretic, diaphoretic,

carminative tonic, anti-rheumatic and to treat
feverish conditions.

English: Tea Bush

Yoruba: Efirin Pupa Osole
Hausa:
Igbo:
Botanical: Lippia multifora

Use: General care in children against disease. The

leaves are also used in the treatment of malaria,
jaundice, pains, headache and diarrhoea

7
It was observed that most of the plants have multiple usage and are used generally by all the
traditional healers (Traditional birth Attendants, bone setters and Massage therapists)
depending on the ailment or need, hence the grouping together of all herbs and plants.

62
English:
Yoruba: Ewe Epin, Ewe Majemu
Hausa: Baure
Igbo:
Botanical: Ficus exasperata, Ficus asperifolia

Use: Leaves used for hot flushes, habitual abortion.

The root is used for treatment of enlarged prostrate
and sexually transmitted diseases (STDs)

English: Pignut
Yoruba: Botuje (Jagbajogbo, Awogbarun,
Lapalapa)
Hausa: Dazugu
Igbo: Owulu
Botanical: Jatropha curcas L.

Use:
1. Concoction of leaves used to sterilize
umbilicus of new born babies
2. To strengthen premature babies and increase
their weight.

English: Hogweed
Yoruba: Etiponola Leaves
Hausa:
Igbo:
Botanical: Boerhavia difusa

Use:
1. The extracts of the leaves used for early
detection of a pregnancy.
2. Seeds and flower used to prepare family
planning ring

63
English:
Yoruba: Ewe Oba
Hausa:
Igbo:
Botanical:

Use: Treatment of hydrocele

English: Cotton Plant

Yoruba: Efe Owu
Hausa:
Igbo:
Botanical: Gossypium hirsutum

Use: The leaves are used for the treatment of

jaundice and for regulating menstrual cycle in
women, the seeds are also used for the treatment of
abdominal pain and malaria.

English: Cotton
Yoruba: Ewe Owu Akese
Hausa:
Igbo:
Botanical: Gossypium barbadense

Use: For the treatment of stomach ache and

abdominal pain

64
English:
Yoruba: Eegun Orun
Hausa:
Igbo:
Botanical: Gratera religiosa

Use: Repellant against evil arrows (Ofa)

English: African bowstring hemp

Yoruba: Oja Ikoko
Hausa:
Igbo:
Botanical: Sansevieria liberica

Use: For the treatment of purulent myosites and

stomach ache

English: Pineapple
Yoruba: Ope Oyinbo
Hausa: Abarbaa
Igbo: Akwu-olu
Botanical: Ananas sativus

Use: The unripe fruit is used as digestive ferment,

coughs and appertiser. The fruits are also used to
treat malaria, arthritis and blennoragia

65
English: Bastard Vervain
Yoruba: Iru Amure
Hausa: Tzarkiyar kuzu
Igbo:
Botanical:

Use:
1. Decoction used for dysentery and as a
worm expellant
2. used as a cold infusion for gonorrhea

English: Mango Tree

Yoruba: Mango
Hausa: Mangwaro
Igbo: Mangolo
Botanical: Mangifera indica

Use:
1. Boiled bark and young foliage leaves
drank to boost haemoglobin
2. As febrifuge, astringent, diuretic,
analgesic and stimulant

English: Neem Plant

Yoruba: Dongoyaro
Hausa: Dongoyaro
Igbo: Dongoyaro
Botanical: Azardiractha indica

Use: The leaves are used as anti inflammatory,

anti-malaria, anti pyretic and analgesic.

66
English: Senna
Yoruba: Asuwon Oyinbo, Asuwon fruit
Hausa:
Igbo: Ogaalu
Botanical: Cassia occidentalis

Uses:
1. Entire plant used to treat venereal
diseases in women
2. Leaves used to treat skin problems
3. Infusion of the leaves as a mild laxative
and purgative in large doses.

English:
Yoruba: Oro oni flower
Hausa:
Igbo:
Botanical:

Use: For protection of pregnant women from

evil forces.

English:
Yoruba: Oro Elewe
Hausa:
Igbo:
Botanical: Harworthia attennanta spp

Use: For protection against evil and for wound

healing

67
English: Cactus
Yoruba: Oro Alabebe, Oro Agogo
Hausa: Kiarana
Igbo:
Botanical: Euphobia deightonii

Use: To treat dermatitis

English: Physic nut, purging nut

Yoruba: Ogege (Paki Orunmila)
Hausa:
Igbo:
Botanical: Jatropha multifida

Use: To treat dental cavities

English:
Yoruba: Enu Opire
Hausa:
Igbo:
Botanical: Euphorbia lateriflora

Use: Treatment of Fibroid and infertility

68
English: Sarsaparilla
Yoruba: Ewe Ewo
Hausa:
Igbo:
Botanical: Similax aspera L

Use:
1. For treatment of skin afflictions
2. Poor indigestion
3. Rhematoid Arthritis

English: Sodom apple

Yoruba: Bomu Bomu
Hausa: Bam bam bele
Igbo:
Botanical: Calotropis procera

Use:
1. Leaves are used to induce breast
milk in women
2. To treat rashes and smallpox
3. Smoke from dried leaves used to
treat asthma

English: Cinnamon Tree

Yoruba: Ewe Agbayun, Igi didun
Hausa:
Igbo:
Botanical: Cinnamomum zeylanicum zees

Use: To enhance immunity and stomach

mobility

69
English: American Tobacco
Yoruba: Taba, Taba Juku
Hausa:
Igbo: Otaba
Edo: Itaba
Botanical: Nicotania tabacum c.

Use: Leaves are used as anti microbial and

stimulant

English: Crinum Lily

Yoruba: Isumeri
Hausa: Albasar Kwadi
Igbo: Ozu, Olodi, Ede Obase
Botanical: Crinuim Yuccaeflorum Salish

Use: To induce vomiting as a labour

precipitate

English:
Yoruba: Sawerepepe
Hausa:
Igbo:
Botanical: Spilanthes Acemella

Use: Concoction for easy delivery

70
English: African Cucumber
Yoruba: Ejirin Leaves
Hausa: Daddagu
Igbo: Alo Ose
Botanical: Momordica charantia

Use:
1. Used as fertility aid for women
2. Decoction of the roots and fruits
is abortifacient
3. used in the treatment of fever

English:
Yoruba: Wonjo, Sikirimindi
Hausa:
Igbo:
Botanical: Urena lobata

Use:
1. For spiritual
treatment/consultations in
pregnancy
2. To boost fertility
3. to treat typhoid fever

English:
Yoruba: Maboyunku
Hausa:
Igbo:
Botanical:

Use: For vaginal delivery without

complications

71
English: fertility tree, tree of life
Yoruba: Epo Akoko
Hausa: Aduruku
Igbo: Ogilisi
Botanical: newbauldia laevis
Uses:
1. For concoction to treat body ache
in pregnancy
2. Used to aid spontaneous delivery as
well as stop bleeding through the
vagina
3. leaves and roots are boiled to treat
fever, convulsion, stomach ache,
migraine and epilepsy
4. Chieftaincy leaf in Yoruba land

English:
Yoruba: Ewe Rinrin, Ewe Adera
Hausa:
Igbo:
Botanical: Perpomilia pellucida

Use: To soften Cervix in labour and

facilitate easy delivery

English: Lemon Leaves

Yoruba: Ewe Osan
Hausa: Leemu
Igbo: Oroma
Botanical: Citrus sinensis

Use:
1. For treatment of fever and as an
evil repellant
2. To treat waist pains

72
English: Velvet Leaf
Yoruba: Jokoje
Hausa: Fiyaka
Igbo: Abakenwo
Botanical: Cissampelos mucronata

Uses:
1. Concoction used for treating
threatened abortion
2. The plant is used as a diuretic and to
normalize menstrual flow in women.

English:
Yoruba: Ogbo leaves
Hausa:
Igbo:
Botanical: Paraquentina nigrescens

Use:
1. Treatment of infertility and for
easy delivery
2. Treatment of helminthiasis.
3. It is also used for spiritual
protection

English: Sessile joyweed

Yoruba: Dagunro
Hausa: Buuzun maraya
Igbo: Nonu
Botanical: Alternanthera repens

Use:
1. Evil Repellant
2. Leaves are also used in the
treatment of cough, epilepsy
and also in abortion threatening
situations.

73
English: Licorice, Crabs Eye
Yoruba: Iwerenjeje, oju Ologbo
Hausa: Idonzakara
Igbo: Otoberebere
Botanical: Abrus precatorius

Use:
1. The leaves are used for the
treatment of cough, insomnia,
pile and wounds
2. The seed is used for
conjuctivitis

English: Worm Seed Plant

Yoruba: Arunpale
Hausa:
Igbo:
Botanical: Chenopodium ambrosioides

Use:
1. The plant is used as an adjunct
with some herbs for the
treatment of dermatosis.
2. It is also used as a worm expeller

English: Couch grass

Yoruba: Ewe Bamisomo
Hausa:
Igbo:
Botanical: Agropyron repens

Use: to treat infertility and for

spiritual protection.

74
English:
Yoruba: Ewe Mafowokanmomi
(Mafowokanmomi Fruit Inset)
Hausa:
Igbo:
Botanical: Acanthospermum hispidum

Use: For spiritual protection from evil

forces.

English:
Yoruba: Gbongbo Ato and Ewe Ato
Hausa:
Igbo:
Botanical: Chasmanthera dependens

Uses: Leaves and juice mixed with shea

butter used as an embrocating liquid for
pains and sprains

English: Cashew Nut Tree

Yoruba: Kaju
Hausa: Kanju
Igbo: Kausu
Botanical: Anacardium occidentale L

Use: The fallen leaves is boiled as a

concoction to facilitate delivery

75
English:
Yoruba: Ojiji leaves
Hausa:
Igbo:
Botanical:

Use:
1. To prepare balm with other herbs
in the treatment of stroke (cerebro
vascular accidents)
2. In powdered form with electric
catfish for stroke patient

English:
Yoruba: Ewe Gbomorin, Dandito, Amuje
Hausa:
Igbo:
Botanical: Staudtia stipitata

Use:

English:
Yoruba: Agunmaniye
Hausa:
Igbo:
Botanical:

Use: To enhance immunity

76
English: Copper leaf plant
Yoruba: Eela, Diwini
Hausa:
Igbo: Abaleboji
Botanical: Acalypha wilkesiana mull

Use: Treatment of Ela (Eczema)

English:
Yoruba: Aran Opolo
Hausa:
Igbo:
Botanical: Heliotropium indicum

Use:

English: Black nightshade

Yoruba: Odu Plant
Hausa: gautan kaji
Igbo: Anara
Botanical: Solanu nigrum

Use:
1. It is a narcotic
2. treatment of conjunctivitis and
convulsion
3. In the treatment of pre and post
partum haemorrhage

77
English:
Yoruba:
Hausa:
Igbo:
Ijaw: Okokodu Stem (Dried Okokodu
leaves inset)
Botanical:

Use: It is used for the treatment of

fracture, arthritis and as an aphrodisiac

English:
Yoruba:
Hausa:
Igbo:
Ijaw: Torugbesa
Botanical:

Use: The stem of the tree when cut into

small bits and soaked in 7-up or sprite is
used to cure all forms of rheumatism.

English:
Yoruba: Oloora, Asofeyeje
Hausa: Wada
Igbo: Akanta
Botanical: Rauvofia Vomitora

Use:
1. Treatment of fracture
2. Used as an anti pyretic
3. for the treatment of insomnia,
malaria, diabetes, psychosis

78
Evidence of Training, Association and Government Support

Evidence of NNMDA promoting indigenous medicine

Evidence of belonging to an association of traditional healers

79
Evidence of Government support and trainings given to some traditional healers

Association certificate displayed by traditional Birth attendant at Ibeju lekki

80
 A Traditional Birth Attendant showing his certificates of recognition

Certificate of association, Traditional and spiritual birth attendant at Badagry

81
 GROUP PHOTOGRAPHS

Group photograph with Traditional Birth Attendants after focus group discussion at
Abeokuta

Group photograph with Traditional Bone Setters after focus group discussion at Abeokuta
Group photograph with traditional healers at Suru Alaba

82
Group photograph with traditional birth Attendants after focus group discussion at Badagry

83
Group Photograph with Traditional Bone Setters and traditional Birth Attendants in Ibeju
Lekki after Focus Group Discussions

84
 Conclusion
The fact that traditional healers provide services to an ample size of people in the communities
visited cannot be faulted. They are also adjudged to provide safety nets to community people
from vulnerability to untimely death due to lack of access to health care services. The high level
of poverty in the country has made access to modern health care services an impossible arena for
poor people. Despite these, the findings of the survey highlighted the need to evolve a
framework for promoting standards in the practice of traditional healers. Despite the testimonies
of near perfection given by most of the TBAs, it was obvious that they still record cases of
maternal deaths most of which are not captured by state records. The discussions held with the
TBAs also confirmed that there are practitioners all around who know little or nothing about the
profession. The TBAs said that they are willing to work with the government in the creation of
standards that would lead to the proper identification of genuine practitioners.

In view of the fact that TBAs and Bone Setters handle issues relating to human health and life,
there is the need to prescribe minimum standard of what a clinic should look like and what
should be available in them. Most of the clinics visited are in bad shape and highly in unhygienic
conditions. If traditional practice must be assisted to thrive in the 21st century, then efforts must
be geared towards supporting them in the provision of facilities. There is also the possibility of
government establishing its own trado-medical healing centres, but the big question here is, will
those practicing in government provided facilities be hired by the government or be working as
private practitioners? The possibility of this can be explored in collaboration with the Nigerian
Natural Medicine and Development Agency (NNMDA), Federal Ministry of Health and the
relevant State Ministries as well as local government authorities.

Although, it was obvious that all the traditional healers spoken to in the course of the survey had
had the opportunity of attending one HIV/AIDS sensitization programme or the other, the
responses that some of them gave to issues around HIV/AIDS are a source of grave concern.
There is the need to continue to sensitize them and not assume that they know as many of them
still have views and ideas that show that their practices may not be free from possible points of
transmission of the HIV.

85
It is worthy of note that none of the traditional bone setters/ body massage therapists visited had
documentary evidence of the extra ordinary cases that they informed the research team members
of having successfully handled in the past while only two traditional birth attendants had any
documentary evidence. Although the need for this was stressed at all sessions, it is important to
support the practice of traditional healers with opportunities for documentation of their healing
methods and the cases that are referred to them from modern medical centres. This will go along
way in promoting the identification of those that are highly skilled as well improve their practice
generally.

There is also the need for continuous sensitization of traditional healers on the need to refer
patients to the next level of care in good time in order to avoid unnecessary deaths in their
clinics. Many of the traditional expressed extremely confidence of their skill and ability to cure
any ailment. However, this is not the situation that available reports gave about their practice.
They also confirmed that they sometimes have cases of death of patient.

The fact that the traditional healers do enormous work at the community level by providing
safety nets to poor people and are also working and contributing to human capital development
calls for the need for government to pay serious attention to the sector. There is a dire need to
explore possible and practicable means of providing support to genuine practitioners. This
process may start with identification and registration of traditional healers as well as the
standardization of their training and practice. Exploring the possibility of standardization of the
practice of traditional healers is inevitable in view of the fact that some of the practices and
methods of administering health services are considered dangerous e.g. A TBA using his hands
to manoeuvre placenta.

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 Appendix I

Question Guide for Focus Group Discussions and Interviews

of Traditional Birth Attendants, Bone Setters and Body
Massage Therapists
1. Kinds of Cases that specific healers handle

2. The traditional healing methods that they use (Is spirituality involved in these or some of
the methods?)

3. Types of
local herbs/plants
animal products do they make use of?
Equipment
that traditional healers use.

4. What measures are taken to safeguard the health of patients in cases of complications?

5. At what point do traditional healers refer patients to modern health care providers?

6. What are the challenges or problems that traditional healers face?

7. Are there areas where they require support?

8. Assess charges for different services offered by traditional bone setters

9. Assess the facilities used by bone setters within the community?

Space
Hygiene
Accessibility etc.

10. Have they been opportune to attend any skills acquisition training? e.g
HIV/AIDS prevention
Hygiene
Management of Complications
Referral Systems

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 Appendix II
List of Participants at Focus Group Discussion Sessions and
Interviewees
Traditional Birth Attendants at Abeokuta
Mr. Rasheed owoyemi (Alias Jagilegbo Sogun, Baba Igbebi)
Mr. Olatoye Adisa Adekunle (Were ni ise Oluwa)
Alhaji Surajudeen Aremu Shittu (Eruobodo Traditional Clinic)
Mrs. Olufunke Ogunrominbi (Dunni Traditional Clinic)
Mr. Kolawole Samuel (Alias Tenigbegi loju)
Mrs Temilola Mathew (Olaiya Traditional Herbalist)

Traditional Birth Attendants at Ibeju-L ekki

Mr. Talim Asafa from Ilagbo
Mr. kamilu Adekoya from Olomowewe
Mr. babatunde Saka from Osoroko Ajegunle
Mr. Lateef Kazeem from Oriaganrigan II
Mr. Tekelu Balogun from Osokoro
Mrs. Suwebatu badiru from Origanrigan
Mr. Mukaila kadejo from Osokoro
Mr. Inuibidin Osikoya from Orolu, a TBA
Mr. K. Yusuf from Otolu(TBA and a Psychiatrist)
Mr. Kehinde Adelaja from Lekki

Traditional Birth Attendants at Badagry

Mr. Z. T.A. Falola from Igborosun
Mr. Jimoh Ogunlana from Ibereko
Mrs. Toyin Yusuf Arigbabuwo
Mrs. Idowu Yusuf from Iragan
Mrs. M. O. Ogunyemi from Ibereko

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 Mr. F. A. Anjorin from Igborosu
Mrs. Josephine Omolabake Oladele
Mrs. Kikelomo Osidipo

Traditional Birth Attendants at Suru Alaba

Mrs. Josephine Omolabake Oladele
Chief Owoyebi Michael Ebija

Bone Setters at Ibeju-Lekki

Mr. Akilu Adams
Mr. Anafi Sule
Mr. Sefiu Sule

Bone Setter at Badagry

Mrs. Abosede Asokere

Bone Setters at Abeokuta

(Osupa Loba Irawo Traditional Healers Ita Agema, Agole Alapoti)
Mrs Kemi Apata
Chief Tunde Bankole
Oloye Siwaju Fagbemi

Bone Setters at Suru Alaba

Prophet Bazim
Mr. Ajadi Aladamo

Body Massage Therapist/Bone Setter

Chief Owoyebi Michael Ebija

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 Appendix III

Field Workers

Community Mobilizers
Mrs. Sunmbo Sola-Philips (Suru Alaba)
Mr. Lakehinde (Ibeju/Lekki)
Mr. Sina Adefolahan (Ogun State)
Mr. Kuton (Badagry)
Mrs. M. A. Dosu, community mobilizer
J. A. Amosu, CAPPA Chairman

Research Team
Atinuke Odukoya
Adebanke Akinrimisi
Olufolake Sholola
Ereola Chris S.

Rapporteurs
Tola Akinlose
Olufolake Solola

Photographer
Atinuke Odukoya

Secretarial Service Support

Sylvia Ibhan

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