ASSESSMENT OF TRADITIONAL HOME REMEDY USAGE AMONG PEOPLE IN HARAR, ETHIOPIA

ASSESSMENT OF TRADITIONAL HOME REMEDY USAGE AMONG PEOPLE IN HARAR, ETHIOPIA

Temesgen berhane and G. Vijaibasker ^*

Haramaya University, School of Pharmacy, College of Health & Medical Sciences, Ethiopia.

ABSTRACT:  Many countries in Africa, Asia and Latin America use traditional medicine (TM) to meet some of their primary health care needs. In Ethiopia, Traditional Medicine (TM) is a part of the national heritage. Also Ethiopia is the home of many nationalities and remarkably diverse flora, including numerous endemic species that are utilized in the different traditional medical practices. Beyond the convenience, traditional home remedies have found favour with a public that wants to take a more holistic approach to its ailments. This study sought to assess the traditional home remedy usage among people in Harar, Ethiopia. The present survey covered the people residing in Kebele 6, Jugal, Harar, Ethiopia. A structured interview questionnaire based on traditional home remedy usage was distributed and face-to-face interviews were conducted. Collected data were tabulated. Among the 338 (100%) respondents, 150 (44%) were males and 188 (56%) were females. 63 (19%) respondents were between the age group of 20 – 25 years, 41 (12%) were between 26 – 30 years, 66 (19%) were between 31 – 35 years, 47 (14%) were between 36 – 40 years and the remaining 121 (36%) were 41 years and above. According to the survey conducted in Kebele 6, Jugal Harar Ethiopia, out of 338 respondents, all were using traditional home remedy. This study contributes to the documentation of the status of current traditional home remedy usage among people in Harar, Ethiopia. Although awareness among traditional home remedy usage is very essential in order to preserve the indigenous medicinal plant species.

Traditional home remedy, traditional medicine, assessment, Jugal, Harar

INTRODUCTION: Since ancient times, plants have been indispensable sources of both preventive and curative traditional medicine preparations for human beings and livestock. Historical accounts of traditionally used medicinal plants depict that different medicinal plants were in use as early as 5000 to 4000 BC in China and 1600 BC by Syrians, Babylonians, Hebrews and Egyptians ¹. Beside their use in fighting various ailments at local level, different medicinal plants are used as export commodities, which generate considerable income ².

It is known that many countries in Africa, Asia and Latin America use traditional medicine (TM) to meet some of their primary health care needs.

In Africa, up to 80% of the population uses traditional medicine for primary health care ³. Traditional medicine has maintained its popularity in all regions of the developing world and its use is rapidly spreading in the industrialized countries. In China, for example, traditional herbal preparations account for 30% - 50% of the total medicinal consumption. In Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicines at home. WHO estimates that in several African countries traditional birth attendants assist in a majority of births ^{3, 4}.

Traditional plant remedies are the most important source of therapeutics for nearly 80% of the developing world population ⁵. Traditional knowledge on plant use will be lost in the absence of continuous cultural interaction ⁶. Demographic, economic, socio-political, ecological, religious and cultural entities existing in a community are key drivers of traditional knowledge in a given community⁷. Various ethno medicinal investigations also show that traditional knowledge on medicinal plants varies depending on different factors including gender, age and occupation ^{8, 9, 10}.

Definition:

The World Health Organization (WHO) defined traditional medicine as health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses and maintain well-being ¹¹. Traditional medicine was once again redefined in 2008 as the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses ¹².

Products made from botanicals that are used to maintain or improve health may be called herbal products or herbal medicines. They come under the class of complementary and alternative medicine (CAM) ¹³. But in many developing countries, medicinal plants have not been well studied, tested or documented. Most of the information is still in the hands of traditional healers and knowledge of healers is either lost or passed to generation by the word of mouth ¹⁴.  

African traditional medicine:

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 ¹⁵. African traditional medicine is the oldest, and perhaps the most assorted, of all therapeutic systems. Africa is considered to be the cradle of mankind with a rich biological and cultural diversity marked by regional differences in healing practices ^{16, 17}. African traditional medicine in its varied forms is holistic involving both the body and the mind. The traditional healer typically diagnoses and treats the psychological basis of an illness before prescribing medicines, particularly medicinal plants to treat the symptoms ^{16, 17, 18}.

Traditional medicine in Ethiopia:

In Ethiopia, Traditional Medicine (TM) is a part of the national heritage ¹⁹. In Ethiopia, the use of traditional medicinal plants is widely practiced. The wide spread use of traditional medicine in Ethiopia could be attributed to cultural acceptability, efficacy against certain type of diseases, physical accessibility and economic affordability as compared to modern medicine. Traditional remedies are the most important and sometimes the only source of therapeutics for nearly 80% of the Ethiopian population and 95% of the preparations are of plant origin ²⁰.

Also Ethiopia is the home of many nationalities and remarkably diverse flora, including numerous endemic species that are utilized in the different traditional medical practices ²¹. In Ethiopia, medicinal plants have been used as traditional medicine to treat different human ailments by the local people from time immemorial. These medicinal plants are estimated to be over 887 species that are currently used by the Ethiopian people ^{22, 23}.

There is a high expectation of enormous traditional knowledge and use of medicinal plant species in Ethiopia due to the existence of diverse cultures, languages and beliefs among the people. However, since cultural systems are dynamic ²⁴, the skills are fragile and easily forgettable as most of the indigenous knowledge transfer in the country is based on oral transmission ²⁵.

There are a number of TMPs that reflect the diversity of Ethiopian cultures. Traditional medical practices related to surgery are bone setting, uvulectomy, bleeding by puncture, cupping, cauterization, scarification and tooth extraction. Others are provision of mineral substances, medicinal plants and animal products. There may also be many unrecognized traditional medical practices in different communities which may influence the health of community in different ways. This indicates that region-specific studies are important ²⁶. In Ethiopia, a brief explanation about the nature of traditional medicine has also been given in the book of “Ethiopian herbal medicine” which was published in the year 2010. It described that many traditional medicinal plants found in Ethiopia were found to be useful and need to be conserved as a natural resources of the country ²⁷. Although TM plays an important role in Ethiopian society, knowledge about the extent and characteristics of traditional medical practices is limited.

According to a population-based survey conducted in Wolayta, 90% of population uses TM in Ethiopia ²⁸. Traditional medicine has remained as the most affordable and easily accessible source of treatment in the primary healthcare system of resource poor communities and the local therapy is the only means of medical treatment for such communities ²⁹. Most of the studies were focused on traditional healers and specific diseased patient groups to assess the traditional medicine usage. This study was therefore aimed at assessing the traditional home remedies usage directly among people. The main objective of the study is to assess traditional home remedy usage among people in Harar, Ethiopia.

MATERIALS AND METHODS:

The study site was Kebele 6, Jugal in Harar, Ethiopia. Harar is the capital city for the Harari Regional State. Harar is located 500km away to east of Addis Ababa and 48km away from Dire Dawa. Based on 2000 (EFY) figures from the Central Statistical Agency (CSA) of Ethiopia, Harari has an estimated total population of 209,000, consisting of 107,000 men and 102,000 women. 37.3% of the population is estimated to be rural inhabitants, while 62.7% are urban dwellers. With an estimated area of 311.25 square kilometers, this region has an estimated density of 629.72 people per square kilometer.

According to the 2000 (EFY) Health and Health Related Indicators Publication by FMOH, Harari has 4 Hospitals, 3 Health Centers and 23 Health Posts ³⁰. The study was designed as a descriptive community based survey design. This approach helped to collect the detailed descriptions of existing variables and use the data to assess the traditional home remedy usage among the people of kebele 6, Jugal in Harar, Ethiopia. The study population was residents of Kebele 6 region in Jugal, Harar, Ethiopia. The sample size was 338 respondents in kebele 6, Jugal in Harar, Ethiopia. Peoples were eligible for the study if they were 18 years of age or older, and people who were available at the time of data collection. Those peoples who were not willing to participate were excluded from the study. The sampling technique used was Convenience Sampling Technique.

The respondents were interviewed on a pre-tested structured questionnaire after their verbal consent. The data was collected by direct face to face interview by disseminating the questionnaire to the people in Kebele 6, Jugal in Harar, Ethiopia. The study was conducted from 15^th March to 29^th April. The data collection instruments were prepared based on the objectives of the study. A structured interview questionnaire based on traditional home remedy usage among people was selected for the study.

Articles, books, journals, published and web-site links were reviewed and used to build up a good tool for the study. The performa developed by the investigators to collect the relevant sample characteristics which contains 10 questions regarding socio-demographic variables such as age, sex, ethnicity, religion, marital status, type of family, educational status, occupation, family income and food habit. These lend a hand to identify the socioeconomic class of resident of kebele 6 in Jugal, Harar Ethiopia.

Structured interview questionnaire consist of 20 questions regarding the use of traditional home remedy among people in kebele 6, Jugal in Harar, Ethiopia. It includes independent variables such as Age, Sex, Ethnicity, Religion, Marital Status, Type of Family, Educational Status, Occupation, Family Income and Food Habit. Dependent variable was traditional home remedy usage.

Investigators personally visited each respondent, introduced them self to the participants and explained the purpose of the study and ascertained the willingness of the participants.

All processes were started after secure the ethical clearance from ethical clearance committee. A signed written consent obtained from the heads of institutions/facilities and head of house hold following an explanation, the purpose, risk and benefit of the study. Confidentiality of the data kept throughout the data collection and the entire study period. Interviews were conducted during their leisure time.

Data processing and analysis were performed by using tally sheet and scientific calculator. Data presentation was performed by using statements and figures. Qualitative data will be processed and analyzed by cross checking the collected data for its completeness and will be used scientific calculator for quantitative data processing and analysis.

RESULTS:

TABLE 1: FREQUENCY AND PERCENTAGE DISTRIBUTION OF SOCIO DEMOGRAPHIC VARIABLES OF RESPONDENTS IN KEBELE 6, JUGAL IN HARAR, ETHIOPIA. N = 338

The demographic characteristics of participants are presented in Table 1. A total of 338 respondents in kebele 6, Jugal in Harar, Ethiopia. Table 1 shows that the socio demographic variables 63 (19%) respondents were between the age group of 20 – 25 years, 41 (12%) were between 26 – 30 years, 66 (19%) were between 31 – 35 years, 47 (14%) were between 36 – 40 years and the remaining 121 (36%) were 41 years and above.

The demographic characteristics of participants are presented in Table 1. Among the 338 (100%) respondents, 150 (44%) were males and 188 (56%) were females. Depending on the ethnicity, 100 (29%) were belongs to Oromia, 53 (16%) were belongs to Amhara, 131 (39%) were belongs to Hadri and 54 (16%) were belongs to others.  It was found that 202 (60%) of the respondents were belonging to Muslim religion, 91 (27%) were belonging to Christian religion and the remaining 45 (13%) were belonging to others. Table 1 shows that 185 (55%) were married, 107 (32%) were unmarried, 18 (5%) were widowed and 28 (8%) were divorced/separated.

It was found that 208 (62%) of the respondents were from nuclear family and 130 (38%) were from joint family. Table 1 shows that 132 (39%) were illiterate, 76 (23%) were completed primary education, 62 (18%) were completed secondary education and 68 (20%) were completed degree and above. Taking occupation, 58 (17%) were farmers, 48 (11%) were coolie, 96 (29%) were doing business, 68 (20%) were government employees and remaining 20 (6%) were belongs to other occupation.

It was found that 33 (10%) respondents were having family income between 250 – 500 ETB / month, 59 (17%) were having family income between 500 – 750 ETB / month, 70 (21%) were having family income between 750 – 1000 ETB / month and the remaining 176 (52%) were having family income more than 1000 ETB / month. Depending on the food habit, 64 (19%) were vegetarian and 274 (81%) were taking mixed food.

According to the survey conducted in Kebele 6, Jugal Harar Ethiopia, out of 338 respondents, all were using traditional home remedy. Table 2 shows that, 56 (17%) were using Ginger for treating abdominal cramps, 120 (36%) for common cold, 130 (38%) for tonsillitis and 32 (9%) does not use ginger for treating the above ailments. It was found that 118 (35%) were using Echinops kebericho mesfin as insect repellant, 98 (29%) were using as corpse preservation and 122 (36%) does not use echinops kebericho mesfin for treating any diseases. It was found that 67 (20%) were using fennel as a treatment for menstrual problems, 37 (11%) were using it to increase lactation, 60 (18%) for cleansing the skin and make it shiny and 174 (51%) does not use fennel for treating any illnesses.

Table shows that 22 (7%) were using eucalyptus for treating malaria, 28 (8%) for typhoid, 75 (22%) for treating acute sickness and the remaining 213 (63%) were using eucalyptus for getting relief from common cold. It was found that 133 (39%) were using hagenia abyssinica for tape worm infestation, 83 (25%) were using it to treat stomach ache and remaining 122 (36%) were using hagenia abyssinica to cleanse their stomach before starting fasting. Depending on the usage of allium sativum, 53 (15%) were using as the treatment for hemorrhoids, 30 (9%) were using for body itching, 111 (33%) were using for common cold and the remaining 144 (43%) were using allium sativum as a food spice instead of using it as medicine.

Table shows that 96 (28%) were using ocimum lamifolium for common cold, 20 (6%) were using it to heal the wound, 47 (14%) for head ache and the remaining 175 (52%) were using ocimum lamifolium for getting relief from itching. Depending on the usage of lemon, 113 (34%) were using for stomach ache, 108 (32%) for body odour, 25 (7%) were using for wound healing and remaining 92 (27%) for the treatment of common cold.

It was found that 25 (7%) were using ociumum basilicum to treat malaria, 161 (48%) does not use ociumum as a traditional medicine and 152 (45%) were using as a food spice. Among 338 respondents, most of them were using chata edulis for relaxation 107 (32%) and addiction 133 (39%), only 38 (11%) were using chata edulis as a traditional medicine for treating head ache. None of them were using chata edulis for treating tonsillitis, stomach ache and body odour.

Table shows that 98 (29%) were using black mustard for treating stomach ache, 64 (19%) were using it to treat constipation, 46 (14%) for wound dressing and the remaining 130 (38%) were using black mustard for other purpose like food spice. It was found that 169 (50%) were using black seed for treating stomach ache, 104 (31%) for head ache and remaining 65 (19%) were using black seed for abortion.

Depending on the usage of linum usitatissimum, 49 (14%) were using to ease hot flashes in pregnant women, 128 (38%) were using to cleanse the birth canal right after child birth and the remaining 161 (48%) were using linum usitatissimum for gastric problems. It was found that 156 (46%) were using pepper mint for common cold and the remaining 182 (54%) for head ache.

Table shows that 75 (22%) were using taverniera abyssinica for stomach ache, 164 (49%) for acute sickness and 99 (29%) does not use taverniera abyssinica as traditional medicine. None of them were using taymiera abyssinica for gastritis and cough. It was found that 121 (36%) were using moringa stenopetala for diabetes, 125 (37%) were using for hypertension, 43 (13%) were using for heart disease and 49 (14%) were using moringa stenopetala for kidney infection.

It was found that 103 (31%) were using rue- rutachalepensis for common cold, 190 (56%) for stomach ache and 45 (13%) were using to treat diarrhea. Table shows that 59 (17%) were using fenugreek to treat stomach ache, 66 (20%) were using to heal the wound and remaining 213 (63%) were using fenugreek as a cultural food. Depending on the usage of coriander sativum, none of them were using it for the treatment of loss of appetite, stomach ache, hypertension and tooth ache. Most of them138 (41%) were using coriander sativum as food spice and remaining 200 (59%) does not use coriander sativum as a traditional medicine.

TABLE 2: FREQUENCY AND PERCENTAGE TO ASSESS THE TRADITIONAL HOME REMEDY USAGE IN KEBELE 6, JUGAL, HARAR. N = 338

DISCUSSION: This study highlights the use of traditional home remedy in kebele 6, Jugal Harar Ethiopia. The prevalence of traditional home remedy usage in the present study was found to be similar to the previous studies report by Boyed el,et al. The study was conducted to examine home remedy usage by African American. According to the study Age, Gender, Living with grandparents and educational status of parents has great impact. When we see the present study there was 150(44%) and 188(56%) female. Most of them 121(36%) are above the age of 41 with educational status of no formal education/illiterate132 (39%) ³¹.

Birhan et al reported from a study conducted in Addis Ababa that traditional healer’s clinics considerably contribute to public health care in Addis Ababa. The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoid, fracture, paralysis, liver disease and cancer ³².  Consistent with this study the present study shows that the use of traditional home remedy for different types of ailments. For example, out of 338 respondents for the treatment of wound they use ocimum lamifolium 20(6%), Lemmon 25(7%), black mustard 46(14%) and fenugreek 66(20%), for the treatment of hemorrhoids they use allium sativum L 53(15%). This habit of traditional home remedy usage may be due to the easily availability and cost of modern medicine.

CONCLUSION: Home remedy usage, as a component of self-care, represents an interest and a desire for patient involvement in health care. The use of traditional home remedy was common among people in Ethiopia, was underpinned by the belief that they are effective. This study contributes to the documentation of the status of current traditional home remedy usage among people in Harar, Ethiopia. Although awareness among traditional home remedy usage is very essential in order to preserve the indigenous medicinal plant species.

Competing Interests: The authors declare that they have no competing interest.

ACKNOWLEDGEMENTS: The authors are thankful to the residents of kebele 6, Jugal in Harar, Ethiopia. The authors were also grateful to the staffs from Haramaya University for their kind cooperation to fulfill this study.

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    How to cite this article:

    Berhane T and Vijaibasker G: Assessment of Traditional Home Remedy Usage among People in Harar, Ethiopia. Int J Pharm Sci Res 2015; 6(6): 2451-62.doi: 10.13040/IJPSR.0975-8232.6(6).2451-61.

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