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When local healing confounds modern medicine

Monday July 6 2015

By BITANGE NDEMO
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Three months ago, my left ear got blocked and it became a source of great frustration. I have so far consulted at least three different Ear Nose and Throat (ENT) specialists.

Almost all of them prescribed decongestants, steroids, chewing of gum, yawning regularly, even when unnecessary, and an exercise called Valsalva manoeuvre which involves moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon.

I was getting more agitated, given the fact that the condition had lasted more than the seven-day threshold after which you rule out minor causes like the common cold. At least this is the information I was getting from internet searches.

As the condition persisted, I intensified my search for a solution and the more I looked, the more frustrated I became. Fear too, intensified. 

As usual, doctors start with simple solutions before getting into more complex interventions like endoscopies. 

The initial diagnosis was that my Eustachian tube, a small passageway that connects the upper part of the throat (pharynx) to your middle ears and runs into the oesophagus (the food pipe), may have collapsed.



The Ear: GRAPHIC | BUPA HEALTH
The Ear: GRAPHIC | BUPA HEALTH

They would simply explain to me that when you sneeze, swallow or yawn, your Eustachian tubes open, allowing air to flow in and out but none could give an explanation why it would collapse. 

In essence, the role of the tube is to balance pressure on either side of the eardrum.  In the absence of a reasonable explanation, I did more searching on the internet.  

Some of the causes include blocked nose or thick mucus that develops during a cold or other infections. An infection may also cause the lining of the Eustachian tube to become inflamed and swollen.

MISSING A FAMILY FUNCTION

Most people will have had one or more episodes in their life when they had a cold and found that they could not hear so well due to Eustachian Tube Dysfunction (ETD). 

Glue ear, a condition where the middle ear fills with glue-like fluid, may also cause ear problems. The Eustachian tube becomes congested and prevents the free flow of air into the middle ear, causing the difference in air pressure mentioned above.

Air travel and allergies too can cause ETD, but the more serious cause is what the literature refers to as blockages as a result of enlarged adenoids or tumours that develop at the back of the nose, which usually cause other symptoms in addition to ETD.  Obviously such reads would cause anyone sleepless nights.

At some point, the ear was causing pain and as I tried to excuse myself from a family function, a relative from Pokot asked to know what my problem was. I reluctantly told her what was frustrating me. 

She chuckled. “Only that?  Have you tried chicken oil,” she asked.  “Chicken oil?” I asked.  Yes. She responded.

I ignored her but as the pain persisted I decided that I would try anything.  We bought chicken, removed the fat, boiled it and let it cool.  At night, I put two drops into my ear, and the following morning I was as fit as a fiddle. 

CLINICAL TRIAL FOR CHICKEN OIL

The following week I visited Prof. Macharia, a leading ENT expert in Africa.  He was one of the experts I had consulted earlier and had asked me to go back for a review. 

I narrated my healing process.  He was confounded and told me me that there is no opening through which a liquid can go from the outer ear into the middle ear. 

What I was telling him sounded impossible, but as we deliberated he conceded that use of chicken oil to treat ear problems was common, not just among the Pokot but even his own Kikuyu people, even though he himself thought it was a primitive intervention.

He nevertheless, performed an endoscopy to check if the Eustachian tube was functioned properly and, surprise, surprise, it was working well.

I asked Prof Macharia: can we accept that there are things in nature that we do not know? Isn’t research an attempt to know more than we know today? Could we have clinical trials on this local knowledge?

Reluctantly, being a scientist and perhaps thinking that I could be some eccentric non-scientist, he conceded once more that there could be a basis for trials.

I saw in him the willingness to do such trials because, as Donald Rumsfeld once put it, there are known unknowns.  There are things we know of that somehow are unknown to us. 

DISAPPEARING LOCAL KNOWLEDGE

Our discussion drifted into other areas in which we have failed to perfect local content.  He tells me of a story where some Indian company wanted to sell products that were obviously Jua Kali

This was about 25 years ago and these simple products could not match German technology, which we preferred. Today, products from that company compare favourably with the Germany competitor.

They learnt from their mistakes in what engineers call a learning curve. If we nurtured our local knowledge and made contribution to science through our findings, we too would become part of the global innovation process.

In my excitement, I retold the story of my ear recovery to many other people, and to my surprise, there were numerous testimonies of a similar nature.  I began to ask myself what could have gone wrong with us.

Should there be a local knowledge policy? 

Africa had systems and local knowledge that sustained us, but that is all disappearing fast.  There is a case for scientists to authenticate some local medicines, like the concoction that brought Tanzania’s Loliondo into the limelight. 

These claims could be the basis of hypotheses for scientists to begin inquiries into the claims, isolate and validate medicinal elements and confirm their treatment and even palliative promise.

Unfortunately, we have left this to a few opportunists; commercial herbalists who have taken it upon themselves to make unsubstantiated claims that they can treat even the most complex diseases.

THE HOODIA CASE

There have been cases in Africa where indigenous knowledge is suppressed. For example, in South Africa and Namibia, a leafless plant with medicinal properties, Hoodia gordonii, that has been used by the Bushmen for centuries is said to have been discovered by Col Robert Jacob Gordon around the Orange River in about 1779. 

Years later in 1977, an article in the Los Angeles Times of December 26, 2006, confirmed that in 1977, the South African Council for Scientific and Industrial Research (CSIR) isolated the ingredient in hoodia—now known as P57—which may be responsible for its putative appetite-suppressant effect, and patented it in 1996.

The CSIR later granted a licence to multinational drug companies to isolate active ingredients from the extracts and look into synthesising them for use as an appetite suppressant. Research into Hoodia was stopped due to what they said was difficulty in synthesising it. 

In 2002, CSIR officially recognised theSan tribespeople’srights over Hoodia, allowing them to take a percentage of the profits and any spin-offs resulting from its as an anti-obesity drug.

The indigenous people continue to use the plant to suppress hunger, and in the process, protect themselves from obesity.

Research shows that some giant drug makers patent products in order to protect their existing sales. For example, if an anti-obesity drug threatens sales in diabetes, they will undermine it to protect their sales from existing drugs.

GOOD FOR THE PROSTATE

That perhaps is the reason why the San people should work towards independent research to come up with an anti-obesity drug by themselves. 

Professor Julius Mwangi at the School of Pharmacy, University of Nairobi, has been working to bridge the gap between traditional herbal medicines and conventional medicines. 

Hechronicles many casesin which conventional medicines failed but traditional cures succeeded.  For example he wrote:

“A 17 year old girl had a severe skin allergic reactions to beans. She was put on topical steroids, non-steroidal anti-inflammatory agents and antibiotics. These did not help. She was later put on a traditional herbal medicine containing 15 items, some of which were powders or some liquids.  The problem was solved in three weeks.”

When I caught up with Prof. Mwangi, he confirmed that many remedies which emanated from traditional medicine have become global products. 

Africans have used Prunus Africana (muiri in Kikuyu) to treat prostrate diseases without any scientific proof, but some studies now show that extracts from the tree are indeed good for the prostrate.

The bark of this tree used to be boiled and added as a soup additive.  Several non-patented products including herbal tea, soaps and insect repellants have been developed from this plant. 

INNOVATIONS OF OUR FOREFATHERS

Active studies of many of our voodoo-like treatments may lead to greater economic products and job creation when we scientifically authenticate indigenous knowledge.

In some cases, we may reduce our healthcare spend.  It is in our interest to incrementally scientifically validate the innovations and discoveries of our forefathers.

In his inaugural lecture, Prof. Mwangi quoted from World Health Organization (WHO) reports of 2002 and 2005 that say many African countries including Ghana, Mali, Nigeria and Rwanda have in place a national policy, a legal framework, a national coordinating body and a national budgetary allocation for complementary medicine.

Madagascar for example, has over 40-plant based medicines in its healthcare system developed by the Institute for Research Application.

Aldous Huxley, an English writer and philosopher, once said “There is only one corner of the universe you can be certain of improving, and that's your own self.” 

We must individually strive to improve some of the “known unknowns” if Africa is to collectively leverage past knowledge to build a future.

The writer is an Associate Professor at University of Nairobi’s Business School. Twitter:@bantigito