MEDICINE?
WHO defined traditional medicine as comprising therapeutic practices that have been in existence for hundreds of years, before the development  and spread of modern scientific medicine and are still in use today. These practices vary widely, in keeping with the social and cultural heritage in different countries (WHO, 1978 & 1991).
Sofowora (1993) defined Traditional Medicine as the total combination of knowledge and practices, whether explicable or not, used in diagnosing, preventing or eliminating a physical, mental or social disease and which may rely exclusively on past experience and observation handed down from generation to generation verbally or in writing.
Traditional medicine is the type of medicine that makes use of plant materials, animal, mineral substances, etc. to effect healing in accordance with the tradition of a people. It is practiced all over the world and is variously referred to as indigenous or folk medicine. Its processes and procedures vary from society to society, culture to culture. In Africa, it embraces ‘the original concept of nature which includes the material world, the sociological environment, whether living or dead and the metaphysical forces of the universe’ (Lewis, 1981).
Practitioners of this type of medicine are highly regarded in their communities and they are among the leaders of the people. Their methods of healing are usually based on socio-cultural factors and governed by knowledge, attitudes and beliefs prevalent among the people.
TRADITIONAL METHOD OF BIRTH CONTROL
“The desire for birth control is neither time nor space bound. Ii is a universal characteristic of social life.”
Delano (1988) defined traditional methods of birth control as the practice, beliefs or customs handed down from one generation to another aimed at preventing pregnancy.
Birth Control In Ancient Times
Ethnographers at different times studied various primitive tribes in the first stage of development (Stone age, iron age etc.) and discovered that among these peoples, various taboos, different socio-cultural and mystical practices guided the relationship between women and men. According to Seregély, 1981, at this period in the history of mankind, the connection between the birth of a child and intercourse was not even suspected and the arrival of the child was attributed to the will of gods or idols.
With respect to the practice of contraception there have been many methods which can be considered as the early forerunners of modern birth control and the basic concept of most of them still guide the idea of contraception today. Presumably the first men and women to practice birth control had the same motive as do many couples or individual today. They also wanted to be relieved of the constant confinement of pregnancy, the burden of feeding and caring for new babies at short intervals.
REGIONAL PRACTICES OF
CONTRACEPTION IN
ANCIENT TIMES
Europe
In Europe at this time, women ate different types of seeds and leaves so that their chemical components would help to reduce fertility. These include eating castor oil seeds, ricunus seeds, willow leaves etc.
In some cases, sticky substances were smeared on the genitals (earwax of animals, peppermint oil, honey, etc.) Men also wore sheaths over their penis to prevent pregnancy. These sheaths were made of different materials from animal bladder, intestines, and other membranes. Abortion was also employed as a means of contraception. Women drank herbal preparations, saps from trees, or roots insertion of different herbs into the cervix with the sole aim of induced abortion.
NATIVE AMERICA
Studies conducted on the preventive habits of the natives of America revealed that in North Carolina, Indian women chewed parsley on four successive days to become infertile, while Indians of Mexico abstained from intercourse for 9 days after menstruation. The Eskimos of Baffin Island on the other hand used chronic lactation to reduce the number of their children.
The Far East (China, Japan, India)
One of the oldest Chinese medical records, the Ch’ien Chin Tang (Thousand Golden Formulas), written by Sun Ssu-mo who died in 695 BC teaches:
“Take oil and mercury, bake them for a whole day, take a small ball of it on empty stomach and you will be barren for ever.” In another write up, Tang Shen-wei mentions mercury as an abortive agent. A number of authors are inclined to see a certain intention of birth control in the eunuch system widely accepted in China. Among the magical Chinese customs there is one which advises that a hot iron ball (Moxa), be put on the navel of the woman to prevent her from childbearing.
An old Japanese book documented the use of thin leather called “ryuruskku” used as a tool which prevents the male seminal fluid from reaching the vagina thus prevents  conception. However, we do not know whether this device was introduced into the vaginal cavity or used like a condom. Later descriptions mentioned a physical barrier item, “kabutogata” which was something like condoms made of leather, tortoise membrane and horn. In addition to drinking different herbal brews to prevent conception, the Japanese also practiced coitus interuptus and coitus reservertus.
Misugami (tampon made of thin bamboo leaves soaked in oil) and yoshinnogami (soft paper tampon) were also employed to control birth.
Cooper (1928) described a special vagina lavage, performed by Japanese women to avoid pregnancy. Immediately after sexual intercourse the woman removed the semen from the vagina with her fingers that she repeatedly put into hot water.
Hindu texts from the 4th century AD contain masses of contraceptive suggestions such as passivity during coitus, wearing of various charms, vagina fumigation, tampons made of ground “ajowan” seeds and the intra vaginal application of mixtures of common salt, and oil or honey and oil. These scripts mentioned the practice of coitus obstructus (strangulation of the penis with the fingers during ejaculation “to force the sperm into the bladder”), avoidance of orgasm by intermittent retention of breathing during coitus, religious self-discipline etc. as part of the efforts to control birth.
Southern Oceans
In the eastern islands of Austronesia (now Australia), women who had intercourse with sailors on transit stuffed their vaginal cavity with sea algae, seaweeds and other plants to prevent pregnancy. Vigorous exercises were performed by women of Australian aborigines to expel the sperm from the vagina after intercourse. Sumatra women used intravagina pellets kneaded from opium and a black mass made of an unknown vegetable material which later studies confirmed to have high tannic acid. In Java, Indonesia women regularly performed retroflexion of the uterus while surgical amputation of the uterus was common among Australian women.
Africa
In Africa, the Massai tribe of Kenya adopted coitus interruptus while the South African Thonga tribe practiced Coitus interruptus and coitus reservatus (i.e. suppression of male orgasm). Coitus interruptus was documented to be the most effective of early methods and is still practiced today.
The women of Nandi tribe in East Africa abstained from sexual intercourse for several days after menstruation. In the Island of Madagascar, the murder of infants was the custom, while in the Rif mountains of North Africa unwanted babies were secretly sold at a market. In Dahomey now known as Republic of Benin, West Africa, before intercourse, women plugged the vaginal cavity with roots to prevent the entry of sperm. The physicians of Kwaflgo district in Central Africa reported the stuffing of the posterior part of the vagina with bits of cloth and herbs as contraception. This was discovered by accident treating some serious complications arising from the practice.
During the era of slave trade the women from Guinea shipped to South America used vagina douche. This consisted in post coital irrigation with a solution made from skin of seeds of mahogany tree and lemon juice or placing the large seeds of lemon in the internal cervical OS or the use of the sea algae, or sea weed and pellets kneaded from opium or high tannic.
Nigeria
As in many parts of the world, different types of traditional methods of family planning are being used in Nigeria. Delano (1988), classified traditional methods of contraception broadly into two groups. These are:
·    The Appliance Methods
·    The Non-Appliance Methods
1.    The Appliance Methods
These involve specific preparations by herbalists or traditional healers and dispensed to individuals. Appliance Methods could be herbal preparation taken orally by the woman. This is often administered in the form of specially prepared stew, herbal tea, or chewing stick. The preparation apart from being taken by the woman could be taken, on behalf of the woman, by domestic animals or placed at a circular road as sacrifice to be consumed by the spirits to prevent conception.
Injectable (scarification): This is provided in the form of scarification administered by the herbalist. Seven to twenty one incision are made on the supra pubic or spinal region of the male or female, followed by the application of specially prepared substance presumed to get absorbed through the blood stream as a long acting method of contraception.
BARRIER METHOD
Barrier method consists of both the physical and sperm-killing agents.
Physical Barrier: Of all the traditional methods used, the most sophisticated was the use of a device whose mode of action was similar to the diaphragm or cervical cap. It was in a form of mechanical barrier inserted in advance of intercourse to prevent sperm from entering the cervix. This method that has survived to this day and used widely was the shell of half lime where the flesh was scooped out, and its cup shape used as cervical cap to prevent the sperm from gaining entry through the cervical OS. Another physical method used by African women is vagina plug made of grass-seaweed, dried figs, leaves etc.
Another barrier method used similar to condom and worn by men and women were bladder of goat used to cover the vagina or the penis. It is amazing to state that primitive people in South America still use this method today while the men/young boys have added a wooden funnel shape to cover the penis (CNN September 2006).
Sperm-Killing Agents: Various substances believed to kill sperm were also inserted into the vaginal cavity. Some of these are: honey, vinegar and lemon juice. They may be used alone or in combination with the physical barrier method.
Invisible Barrier Method: In addition to the methods mentioned above, traditional medicine goes a step further, by invoking the supernatural powers to prevent pregnancy. Various practices were performed for religious, mystic or superstitious reasons. Methods used include charms worn by men and women. These consist of metal finger ring, waist-bands, pendants, amulets made from leopard or snake skin believed to have supernatural effect to prevent pregnancy. Another method, is the use of incantation to conjure up forces on a parrots feather (teso’ in Yoruba) or on locked padlock (‘akaraba’ in Yoruba) to act on a girl or women’s vaginal canal resulting in spasmodic effect and preventing entry or penetration of the penis into the vagina.
In addition to these practices, there was a proliferation of magical customs which included the inhalation of the breath of camels, wearing of various charms, placing some insects on the woman’s abdomen, making incisions and drinking concoctions such as drinking of water in which a dead man had been washed.
2.    Non-Appliance Method
These are traditional methods of birth control that do not need the attention of herbalists and are self-administered. They include:
Abstinence
This is the avoidance of sexual intercourse. It is the commonest and most effective pregnancy prevention method which can also prevent sexually transmitted infections and HI V/AIDS provided it is strictly and honestly practiced. It is recognized as a method that has always been used since man was created and became aware of the need to prevent pregnancy in order to space or limit the number of children. This method has always been by personal choice or enforced by culture and religion. This include the following:
Cultural Emphasis on Virginity
The importance placed on virginity, traditionally and culturally, prevents girls from engaging in sex until they are married. Defiance of this custom brings shame and dishonour to the girl and her family. Hence, it is considered a pride to retain virginity until marriage and prevent unwanted.
Abstinence with Prolonged Lactation
This aids child’s survival through uninterrupted and prolonged breast feeding. It is believed that intercourse during breast-feeding could result in contamination of breast milk by sperm and ill-health which could cause the death of the infant.
Avoiding  Sex During Menstruation
It is not only considered unhygienic but also regarded as a taboo for sexual intercourse to take place during the menstrual period. It is believed that if the traditional taboo is violated, the woman will deliver an albino. This, of course, is unfounded but may have helped in checking unintended/unwanted pregnancies.
Polygamy
Having more than one wife allows the nursing mother to abstain from intercourse as she can be isolated from her husband, thus, permitting uninterrupted breast-feeding. It also prevents unintended and unwanted pregnancy. Polygamy enables the husband to satisfy his sexual urge with another wife who is not nursing a baby.
Taboo of Incest
Sex with Blood relations is forbidden culturally, religiously and considered shameful for biologically/blood related individuals to have sexual relations with each other. In some cultures, those involved would be exposed and ridiculed. Such persons were usually forced to relocate out of shame.
Celibacy
Some religious groups prohibit sexual activities by any of the anointed servants of God who have vowed to devote their lives to the service of God. Full commitment to the work of God without distraction is expected from these groups.
Castration of Men who are close servants of traditional kings to enable them dedicate their lives to serving their masters faithfully and prevent them from yielding to temptation with the members of the king’s harem was and is still being practised today.
Physical Exercises
Long before the advent of modern methods of birth control, African women realizing that sperm was responsible for pregnancy adopted various exercises in an attempt to dislodge the sperm and prevent its entry through the cervical OS.
Douching
This may be effective in killing sperm where chances of getting pregnant are slim as it takes less than 90 seconds for sperm to gain entry into the cervical OS. Hot plain water with or without concentrated solutions of salt, alum, vinegar, lemon, potassium or caustic soda have been reportedly used by women. This is dangerous and some of these solutions have resulted in vaginal stenosis (narrowing of the vagina), gynaetresia, permanent sterility or even death.
Abortion
Abortion has also been used as a means of birth control. Traditional method adopted include: Oral administration of a herbal tea prepared from the root of momordical charantia. Application of hot formentation, tight abdominal binder round the supra pubic region or insertion of abortifacient into the cervix to cause dilation of cervix thus causing forceful expulsion of uterine content. Douching with hot saline or other weak herbs are also used or chewing the stick of momordical charantia to stimulate contraction and expulsion of uterine content.
The most gruesome method is the douching with caustic soda or blue which causes severe burning or sloughing of the birth canal and sometimes death of the victim rather than aborting the pregnancy.
The practice of family planning is not alien to Africa. This can be seen from the numerous examples which date even back before the written history of mankind. We can  however do not know whether the various practices were performed strictly for religious, mytical or superstitious reasons. We can however accept, that the idea and practice of limiting the growth of the population existed already in pre historic times. These methods were used in the various parts of the world depending on their Social and cultural attitude and belief. A few of them are still in use among various people today. They form what is now known as traditional method or traditional medicine.
PREVALENCE OF TRADITIONAL
METHOD OF CONTRACEPTION
According to a study, the use of traditional methods is found among approximately 10 percent of married couples in developing countries (Donaldson and Tsui, 1990). The relevance and importance of traditional family planning methods in Nigeria cannot be overemphasized. For instance, the 2003 NDHS survey indic that, while 13 percent of currently married women are using a method of family planning; only 8 percent are using a modern method. This indicates that, 5% of currently married women are using one traditional method of family planning or another.
While the use of more effective modern methods has been the trend, users in some countries have shifted toward greater use of other methods such as rhythm, withdrawal, abstinence and foam (Palmore and Bulatao, 1989). In developed countries, traditional methods are more popular, where approximately 30 percent of married couples choose these methods (Donaldson and Tsui, 1990).
Although pregnancy rates are important, women’s choice of a method is not always motivated by the likelihood of failure of a method; it is often a function of personal preferences as well as circumstances.
The reasons why couples rely on traditional methods are numerous. They include, a lack of knowledge about modern methods and their modes of operation, the greater convenience of methods, fear of actual or perceived side effects of modern method, religious or cultural constraints, high lack of accessibility and high cost. (Hubacher et al  all 1996).
The use of traditional contraceptives was significantly more common among uneducated women and among women aged 20 to 29 years old. The easy accessibility of traditional medical practitioners and the belief that traditional contraceptive devices are devoid of complications, especially among those experienced with modern contraceptive devices, were the main reasons women cited for patronizing the traditional practitioners. (Jinadu eta!, 1997).
In another similar study conducted in Honduras, users of withdrawal method differed significantly from users of modern methods of family planning on several variables. They were younger than users of modern methods, had had few years of education, had fewer living children and were more likely to reside in rural areas. They also differed significantly from modern method users on travel time to a health facility, employment status and possession of a functioning TV, (Habacher et a! 1996). All these outline variables associated with the use of traditional family planning method.
Advantages and Disadvantages of Traditional Medicine
To shun use of traditional birth control method will be like throwing the baby out with the bath water. Recent studies and efforts all over the world have confirmed the relevance of this aspect of medicine, not only in the prevention of diseases, but also in fertility regulation. It is pertinent to state here that, just as orthodox medicine has its advantages and disadvantages, so do the traditional birth control methods. The following are some of the advantage and disadvantages of traditional methods of family planning.
Advantages
1.    Traditional Methods of family planning are cheaper in most cases than orthodox ones.
2.    It is more accessible to the populace.
3.    It enjoys wider and ready acceptance among the people
4.    Traditional medicine is a potential source of new drugs, a source of cheap starting products for the synthesis of known drugs
5.    Some of the methods advocated by this branch of medicine while helping to prevent pregnancy could also prevent HIV/AIDS/STIS, e.g. abstinence.
6.    Traditional remedies are mostly compounded from natural products. For this reason, it has been stated that it is more body- friendly. Though resistance to synthetic drugs is commonplace, resistance to these type of drugs has however not been documented.
7.    Many of the traditional beliefs of pregnancy prevention have no harmful effects on a woman’s health and may help assure her of being in control of her own fertility. E.g. lactational amenorrhea method (LAM) and even other ineffective notions that pregnancy can be prevented when women avoid the sun or. moon at certain times or wear charms including dead spiders, children’s teeth or leopard skin bracelets, jumping up and down or sneezing after sexual intercourse to dislodge the sperm are other examples.
8.    The client enjoys almost automatic good rapport with service provider in a very warm, and informal atmosphere.
9.    Consultation is not time consuming and impersonal.
Disadvantages
1. The efficacy of traditional methods lack scientific proof and evidence.
2.    Traditional medicine lack precise dosage. However though, many practitioners today have introduced measurements into their drug administration.
3.    The unhygienic environment of most practitioners is a minus to the method as it may increase the spread of infection.
4.    The deliberate aura of mysticism woven around the practice to instill fear in the people and force compliance does not make for a good image of the method.
5.    Most barrier methods employed by traditional medicine increase the risk of pelvic inflammatory diseases and infertility.
6.    Some customs and practices may be dangerous or counterproductive and should be discouraged. For instance the practice of female genital mutilation to reduce sexual urge should be discouraged as it is unfounded.
7.    Other counterproductive practices, which may be harmful, include douching with hot water salt, vinegar, lemon or potassium or insertion of weeds and contaminated rags into the vagina.
This  ineffective technique can introduce infection into a woman’s uterus cause permanent damage including infertility.  Other potentially harmful traditional pregnancy prevention traditions include: eating arsenic, castor oil seeds, drinking water used to wash dead bodies, soaking cotton wool in pepper and inserting it into the vagina as a barrier method.
(Trussell  et al 1987)

Related News