The Untold Stories of Africa’s Contribution to Modern Healthcare: The origin of inoculation and a covid success story in Africa

It was evening, and the grim of the silent night had fallen upon Temate, a village which is about 20km from our hometown, Kumawu. My grandfather had 20 acres of vegetable farm nearby and lived in the only cement house in the village. The house was a three-bedroom house with a big compound. Closer to the road was a big mango tree with wooden benches under it. There is no electricity in the village, so whenever I would visit my grandfather, he would set a fire at night to tell me stories, usually about his life. He loves to talk about his life; this may be due to the andropause stage (Astrid M. Horstman et al., 2012), I think. Andropause refers to the gradual decline in the hormones in men as they grow old. Nonetheless, one thing I like about him is the passion and enthusiasm with which he talks. With all his strength and attention, he moves his body to make gestures to accentuate whatever he tells me. On this day, there was a full moon, and the light from the moon had brightened the whole compound. I wanted to set the fire, but he told me it wasn’t necessary since the moon was full and he needed to conserve his firewood. Many kids like me had taken advantage of the full moon and I could hear the noise from neighboring homes of kids playing gleefully many blocks away.

I took my multivitamin drugs, which the doctor I visited a week before had prescribed for me. My curious grandpa asked what drug I was taking, and I told him I had lost appetite after recovering from mild malaria I had some weeks before I visited him. He inquired if my mother had stopped giving my siblings and me the usual morning herbal tea? He then went to my room to burn some repellent. I thought he was going to send me to buy the usual mosquito coil which we use in the city, but he went to his kitchen and brought out some leaves. The leaves looked like long grass and smelled so nice. The aroma reminded me of the sunlight soap we use in the city. I was quick to ask; do they produce sunlight soap from this leaf? And my grandfather replied, what do you think? I think it has a scent similar to the sunlight soap. He then placed some of the leaves on a silver plate and added some fire from the firewood stove in the kitchen and placed it a few meters away from me. To my surprise, no mosquito got near me, and we had a fruitful discussion that night.

One of my mother’s fears was my going to the village right after recovering from malaria, but in the end, I was safer than at home. In a typical Ghanaian home in the city, one would always see a mosquito spray or coil—the main form of mosquito repellent used. Some of the chemicals used in these sprays are very harmful to human health, and the manufacturers advise we leave the rooms unoccupied for hours. I later got to know the leaves he burnt were Citronella (Tracy M. Katz et al. 2008)—a sweetgrass which my grandmother also used to prepare the soup. Citronella has been used as a fragrance, flavor, and insecticide since 1882. Before the use of synthetic insecticides, citronella was used as an insect repellent. The terpenes in the oil block insects’ neural pathways and disrupt their movements and metabolism (Ritter 2006). According to research, citronella was found to interfere with the cation channel in fruit fly (Drosophila spp.) olfactory receptors (Kwon et al. 2010). Aedes, Anopheles, and Culex mosquito adults in replicated studies show similar mechanisms.

My conversation with my grandpa on that day shifted from just the use of sweetgrass as a mosquito repellent to the use of other plants as medicine. Holding cocoyam leaves (“nkotomire”) in his right hand and a lantern in his left hand, he told me the best blood tonic in the world was “nkotomire” stew. Pascal Leterme et al. (2005) show that cocoyam leaves are rich in iron and a good source of iron for red blood cell formation. My Grandfather explained to me how in the past he never took his kids to the hospital not even for vaccination due to the fear of—in his own words—the white men. He told me how the white men fought with them for their lands and used weapons like guns to kill a lot of people including his father. People like him who had experienced the bitter side of the presence of the white always had doubts about the intention of the whites, especially when during those times most of the doctors were whites.

Growing up there was one particular thing I saw in the homes of most native Ghanaians. The first thing you would do in the morning after brushing your teeth was to go for a cup of concoction. A brown pot blackened with smoke from the fire of burning firewood contained the drug in my house. It always had its place among the first shelves you see in any Ghanaian home, but in my house due to some stubborn mice who tried to eat anything they saw in the kitchen, the pot was placed behind the door, and tightly covered with a jute bag. About 100 meters from my house was a wooden fenced garden with a roofing sheet gate. The garden housed most of the herbs we used. As tradition demanded, one is mandated to pick leaves that had fallen from the plant but never pluck a fresh leaf. My mother’s usual combination was mango, pawpaw, pear, orange leaves with ginger, and cloves to give it a nice aroma. They are bitter, but there is a common belief among Africans that the more bitter the drug the more potent it is. Maybe we are right, I guess. Our ancestors before the whites came had traditional healers who took care of them. Some midwives took care of the pregnant women until delivery, and traditional herbalists diagnosed and prescribed herbal preparations for the sick. Irrespective of how the world views African traditional medicine, it is one of the oldest and most probable sources of discovery of new drugs.

One interesting indigenous medical practice I want to talk about is inoculation. According to my grandfather, whenever there was an outbreak of a disease that affected any of their animals as well, then it was a sign the community had to pacify the gods with these animals. Usually, they would kill the animals and do sanctification rituals which involved making an incision on some part of the body with the knife that was used to kill the animal, and the people were healed afterward. As he talked, my eyes were fixed on his gaze while I imagined and pitied them for being barbaric as we were taught in school. Many years afterward I got to know, they weren’t archaic and barbaric but rather ahead of their time. They may have not known the science behind what they were doing, but in effect, they were inoculating the whole community. Inoculation is a set of methods of artificially inducing immunity against various infectious diseases. In modern terms, inoculating a person is referred to as vaccination. Vaccination involves the transfer of weakened microbes, dead inactivated microbes, or the use of a disease-causing organism into a healthy individual by working with the body’s natural defenses to safely develop immunity to disease. This type of infection, however, seldom causes illness, but it does cause the immune system to produce T-lymphocytes (defensive white blood cells that attack cells in the body that have already been infected) and antibodies. Once the imitation infection goes away, the body is left with a supply of “memory” T-lymphocytes, as well as B-lymphocytes that will remember how to fight that disease in the future.

Today, during a time of crises and even in the past, the hope for pandemics has always been vaccines—something the indigenous people of Africa did and the whites who voyaged to colonize saw as barbaric, redundant, and retrogressive. Harriet Washington’s book Medical Apartheid talks about the various advances white doctors made at the expense of the gullible black slaves during the slavery era. She refers to an incident where there was a smallpox outbreak in Boston in the summer of 1721. Some black slaves who were brought from Africa used inoculum from the infected people as a ritual, as the whites called it. The African Americans were led by Cotton Mather who suggested the whites be inoculated to control the outbreak. Williams Douglass, the city’s head physician, resented the idea of inoculation. The white doctors rubbished the medical advice the Africans gave, just as they continue to do today. What did the blacks know about health? What medical certification did they hold to suggest something so new to western medicine? 8000 people in Boston fell sick at that time and 844 died. While one in nine untreated people died, one in every forty of the inoculated died. The whites then may have been swayed by their intellectual ego, but the statistics could not be argued. The whites didn’t have any option other than to inoculate their people and smallpox left.

This isn’t the only contribution African Americans have made towards modern medicine. Until Alexander Fleming discovered antibiotics in 1928, the main source of drugs for almost every disease was natural resources. Many modern complex vital drugs which our societies depend on today have their source from plants. Herbal preparations today have little or no room in modern advanced medicine, but they are the root of most medicines. Drugs such as Taxol, which is classified by the World Health Organization as an essential drug for cancer patients, were discovered from plants. One would have thought: why not synthesize it? The chemical structure of Taxol is unique and very complex, and as of today, scientists have not been able to synthesize it in the lab; however, it has been enhanced synthetically from the raw material into more effective forms. Taxol today offers better treatment outcomes: increased life expectancy and improved quality of life for cancer patients. Imagine if Mansukh Wani and Monroe Wall, who discovered the life-changing cancer drug, had shied away from indigenous drugs. What would have been the fate of many cancer patients around the world?

Today when you hear of vaccines and drugs such as Taxol, the western science communities make them sound foreign to the normal indigenous African ears. They make it seem like some strange discovery which Africa has never seen before, but is that the case? We are the source of inspiration for vaccines and many other drugs like Taxol. Africa has large forests with myriad plants, and we have myriad water bodies among others which are all potential sources of drug discovery. We may not have advanced technologies to make modern vaccines or enhance the features of a drug, but the truth stands that our indigenous practices are very important and central to the survival of the world today. During the peak of the Covid pandemic around the globe, several reputable organizations including the World Health Organization predicted a high death rate in Africa. They cited reasons such as inadequate medical facilities and low medical professional to patient ratios among others, but we are yet to see these predictions in Africa. Although there have been deaths associated with Covid-19 in Africa, the number of deaths is the lowest in the world according to the Johns Hopkins covid data center. Many epidemiologist experts wonder about these figures, and some make outrageous assumptions such as linking the low covid rate in Africa to poverty (BBC 2020). Some attribute the success to less testing among other reasons. It may be true our testing rate isn’t as high as in Western countries, but the success in Africa is more than a stroke of mere luck. Many Africans from the onset of the pandemic went back to the use of herbs. Many food and drug authorities in Africa have a slow drug approval rate and some lack the courage to approve herbal drugs for covid. Notwithstanding, this didn’t prevent Africans from using some of these herbal drugs. Although the drugs were untested, countries like Madagascar boldly presented an herbal preparation, which the WHO condemned, with many experts doubting it even before a formal test was done on it. They may have been condemned, but the fact remains that Madagascar has one of the lowest covid death rates in the world. According to the WHO Global Report on Traditional and Complementary Medicine (2019), about 85% of Africans use herbal preparations. Most of these herbal drugs may not be potent enough to eradicate the covid virus from the body, but they are potent immune boosters that make the users’ immune systems stronger to help overcome a possible infection.

A day after Ghana recorded her first covid case, my mother went to the market to buy ginger and lemon and went for neem tree leaves from our community garden. She took a big pot and boiled the three ingredients in it. We drank some in the morning and evening. We bathed with neem tree and did aromatherapy with the boiled ingredients. Aromatherapy involves the holistic healing process that uses natural plants and oil to promote well-being through inhalation of the aroma from the essential oils in the plant materials. Covid devastated many homes in Western countries, and many later went to the use of herbal immune boosters. Immune boosters may not be a cure for covid, but a stronger immune system makes one less prone to having covid. The actions that were taken by many Africans, including in my home weren’t a western method of healthcare. They were indigenous, and have contributed so much to the success of Africa in the fight against covid. We may not be rich and literate like people from other continents, but we have an indigenous tradition left behind in our bosom by our ancestors which rises to help us in times of need. Maybe it is high time the western scientists appreciated the effort of indigenous Africans and learned from us.