Women's folk knowledge existed in undocumented parallel with these texts. Francisco Hernández , physician to Philip II of Spain spent the years — gathering information in Mexico and then wrote Rerum Medicarum Novae Hispaniae Thesaurus , many versions of which have been published including one by Francisco Ximénez.

Both Hernandez and Ximenez fitted Aztec ethnomedicinal information into the European concepts of disease such as "warm", "cold", and "moist", but it is not clear that the Aztecs used these categories.

Martín de la Cruz wrote a herbal in Nahuatl which was translated into Latin by Juan Badiano as Libellus de Medicinalibus Indorum Herbis or Codex Barberini, Latin and given to King Carlos V of Spain in Fray Bernardino de Sahagún 's used ethnographic methods to compile his codices that then became the Historia General de las Cosas de Nueva España , published in It was translated into German in and Italian editions were published for the next century.

In 17th and 18th-century America, traditional folk healers, frequently women, used herbal remedies, cupping and leeching. The prevalence of folk medicine in certain areas of the world varies according to cultural norms.

Indigenous medicine is generally transmitted orally through a community, family and individuals until "collected". Within a given culture, elements of indigenous medicine knowledge may be diffusely known by many, or may be gathered and applied by those in a specific role of healer such as a shaman or midwife.

Traditional medicine may sometimes be considered as distinct from folk medicine, and considered to include formalized aspects of folk medicine. Under this definition folk medicine are longstanding remedies and practises passed on and practiced by lay people.

Folk medicine consists of the healing modalities, ideas of body physiology and health preservation known to some in a culture, transmitted informally as general knowledge, and practiced or applied by anyone in the culture having prior experience.

Many countries have practices described as folk medicine which may coexist with formalized, science-based, and institutionalized systems of medical practice represented by conventional medicine. Generally, bush medicine used by Aboriginal and Torres Strait Islander people in Australia is made from plant materials, such as bark, leaves and seeds, although animal products may be used as well.

American Native and Alaska Native medicine are traditional forms of healing that have been around for thousands of years. There are many ethnobotany plants involved in traditional medicine for Native Americans and some are still used today.

When it comes to Native American traditional medicine, the ideas surrounding health and illness within the culture are virtually inseparable from the ideas of religion and spirituality.

Nattuvaidyam was a set of indigenous medical practices that existed in India before the advent of allopathic or western medicine.

There were overlaps and borrowing of ideas, medicinal compounds used and techniques within these practices. while others were handed down orally through various mnemonic devices.

Ayurveda was one kind of nattuvaidyam practised in south India. When the medical system was revamped in twentieth century India, many of the practices and techniques specific to some of these diverse nattuvaidyam were included in Ayurveda.

A home remedy sometimes also referred to as a granny cure is a treatment to cure a disease or ailment that employs certain spices, herbs , vegetables, or other common items.

Home remedies may or may not have medicinal properties that treat or cure the disease or ailment in question, as they are typically passed along by laypersons which has been facilitated in recent years by the Internet.

Many are merely used as a result of tradition or habit or because they are effective in inducing the placebo effect. One of the more popular examples of a home remedy is the use of chicken soup to treat respiratory infections such as a cold or mild flu.

Other examples of home remedies include duct tape to help with setting broken bones; duct tape or superglue to treat plantar warts ; and Kogel mogel to treat sore throat. In earlier times, mothers were entrusted with all but serious remedies. Historic cookbooks are frequently full of remedies for dyspepsia , fevers, and female complaints.

In Chinese folk medicine, medicinal congees long-cooked rice soups with herbs , foods, and soups are part of treatment practices. Although countries have regulations on folk medicines, there are risks associated with the use of them i.

zoonosis , mainly as some traditional medicines still use animal-based substances [47] [48]. It is often assumed that because supposed medicines are natural that they are safe, but numerous precautions are associated with using herbal remedies.

Endangered animals, such as the slow loris , are sometimes killed to make traditional medicines. Shark fins have also been used in traditional medicine, and although their effectiveness has not been proven, it is hurting shark populations and their ecosystem.

The illegal ivory trade can partially be traced back to buyers of traditional Chinese medicine. Demand for ivory is a huge factor in the poaching of endangered species such as rhinos and elephants.

Pangolins are threatened by poaching for their meat and scales, which are used in traditional medicine. They are the most trafficked mammals in the world. North America. South America. Contents move to sidebar hide. Article Talk. Read Edit View history. Tools Tools. What links here Related changes Upload file Special pages Permanent link Page information Cite this page Get shortened URL Download QR code Wikidata item.

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Adrenal fatigue Aerotoxic syndrome Candida hypersensitivity Chronic Lyme disease Electromagnetic hypersensitivity Heavy legs Leaky gut syndrome Multiple chemical sensitivity Wilson's temperature syndrome.

Further information: Medicine in ancient Greece and Medicine in ancient Rome. Further information: Medicine in medieval Islam and Medieval medicine of Western Europe. Main article: Bush medicine. Further information: Native American ethnobotany and Traditional Alaska Native medicine.

Due to increased migration dynamics in both contexts of younger populations moving to the urban places in search of alternative livelihoods, this form of training is becoming increasingly rare for the youth given the long distances to the ritual sites, which involves many days' travel.

Through the cure of a prolonged ailment, some chose to become practitioners themselves after a period of training with an older TH for up to 3 years. The suffering itself was then seen as part of and even a requisite for the learning process.

I was hurting. After I was healed I started to treat others one by one female TH, Magu. The research revealed that becoming a TP at a later age, sometimes through own illness, frequently took place outside the home area of the trainee, and often even outside the country of origin. After graduation, a number of these trainees migrate back to their original homes and set up their own village hospitals.

The latter was seen more often in Tanzania than in Kenya. We have given many who now have their own villages, more than 10 persons, they are now in Dar es Salaam, Musoma, Tarime… … and also Kenya male TH Magu.

Those who I am giving the system, they may in the future provide even better ways of treating and having a central role, perhaps they will be able to treat even better than I do, make TMK even have a bigger role, they may improvise Male TH 67 years.

Homabay, Kenya. The gift is supposed to be used to help cure ailments and societal problems. It is the duty of the traditional practitioner to act as a medium through which this gift is shared with individuals within the society who may need it, thus diffusion of the knowledge is central. You see someone whose heart is good … You do not just give it to anyone… if you see someone who is hurting then you have sympathy for helping him… so then a lot of discoveries can come out of that medicine for you … female TBA Homabay.

Those who I am giving the system, they may in the future provide even better ways of treating, they perhaps will be able to treat even better than I do, there may be improvising male TH HB.

TPs linked this negative knowledge diffusion to outmigration, with potentially negative effects on patients:. Adding someone's knowledge as it was added to me, I still find it difficult in one way.

There was someone with a good idea and they took him and gave him a job. Then it happened that he was sent away from the work. Then you know that those people have remained with all his ideas…and then they take the customers that you used to get male TH Gem. Many herbalists think the medicines which I have, they should also have, so they take them…at times they give wrong medicines and overdose them, which can injure people male TH HB.

The discussion on sorcery arises in the empirical data, particularly within the context of ethics and socio-cultural and socio-economic problems. In all interviews, this phenomenon was mentioned and vehemently criticized by the TPs and authorities. In the citations above, the fears were in particular related to the mobile younger generation's uses of TMK.

Dynamic changes in societal processes in the communities linked to migration and urbanization highlighted the role of parents, who sometimes feared and critiqued the TP's work:. Parents think it is negative and they have fear male TH Gem. Some fear and accuse the young people of learning how to bewitch and kill people… male TH Gem.

The family and household need to have a consensus on if the TMK can be taught to the youth female TH Gem. Some of the TPs who were interviewed had future plans to expand premises for patients both in rural and urban areas.

In particular in Tanzania, commonly mentioned were plans to cultivate medicinal plants on land already purchased and acquired for this purpose. Some TPs saw the way forward in finding new ways of combining TMK learning with formal education, thus bridging rural practices with urban educational and market opportunities.

While expressing concerns about the future generations, many respondents nevertheless stressed that youth are interested and wish to practice as TPs. We found learning processes that combined formal medical education with TMK, and some traditional practitioners, who themselves had formal western education, encouraged their offspring to complete their education before pursuing work with traditional medicine.

Are the youth interested in learning about traditional medicine? Very much. The moment they learn this they want to continue…I say they should finish school first, and to those who have finished, I teach the treatment male TH HB.

There is another one who tried to read, and recently went to the college of medicine. Now he has finished and is at home… you see he has inherited male TH HB.

I used to teach both modern medicine and traditional medicine. People come and I also refer to the hospital. Every 2 days they come and I give advice male TH, Suba.

In our study area, we found several cases of medical pluralism We understand medical pluralism as the consultation of both traditional and western medical practices.

Some Wasukuma practitioners explicitly recognized the benefits of modern medicine, and several of our respondents suggested that there are certain ailments that only a traditional healer can cure, yet there are other sicknesses that a modern hospital can more readily heal with technologies such as intravenous fluids and store-bought medicines.

Pragmatic considerations were common, but forms of true cooperation between the two systems were rare. The interactions between traditional and modern health systems were related to rural—urban inequalities and did not take place without complications.

We found only a few cases of close cooperation between practitioners and modern health systems, such as when the TP referred his patients to hospitals, and one practitioner received patients from the hospitals and organized a transportation system to facilitate the interaction between his village and the urban hospital.

The growing disenchantment with farming as a way of life has made young rural based people in both Mwanza and Nyanza to migrate and actively diversify into non-agricultural activities.

Rural-based TMK is not perceived as a viable long term livelihood strategy for the younger generation, but some traditional practitioners envisioned a strategy for young people to become practitioners by way of combining formal medical studies in the urban area and then return to the rural area for training as a TP.

Two respondents had sons who were attending urban formal education and intended to complete it before continuing working with traditional medicine in the rural setting. Another respondent's son, who was 18 years old, had decided to become a doctor in formal medicine and thereafter practice as a traditional healer.

TPs testified that it has become more common that younger TPs are trained in both systems. The younger populations attribute lower value to TMK which indicates rising challenges of TMK and its transmission to further generations of TPs.

With the introduction of formal western education during the colonial and postcolonial eras, there was a disdain for traditional knowledge, and children were expected to abandon previous learning systems Miller, Despite the continued use and importance of TMK, this legacy contributes to prevailing negative perceptions and suspicions about learning TMK.

The traditional practitioners interviewed in this study described how environmental pressure, migration of the youth, and socio-spatial changes in the study area over the last three decades have created new challenges for TMK practices. Some were concerned about negative values about TMK in the younger generation, while others stressed the will of young people to engage in training and become practitioners.

The youth's keen interest to learn was seen to increase when they viewed improved livelihood possibilities of THs due to the commercialization of medicinal plants, especially in the outmigration spaces.

Some of the interviewed practitioners pointed out the missing link between TMK learning processes and the formal education system. Our study showed a strong influence of modern education in affecting the perceptions and access of the youth to TMK.

With this opportunity, the youth who migrate to attend modern education have limited time if any to learn TMK. The future of TMK learning processes may be limited unless incentives are in place for the youth, regarding their future livelihoods. Odore argues that in Africa, colonial science and education are knowledge on Africa.

The problem today is how to make it knowledge by Africans for their own collective promotion and development. The Wasukuma and Luo's youth livelihoods are increasingly merging into circumstances that place a lower value on their traditional medicinal knowledge.

Under this pressure, traditional knowledge of medicinal plants is starting to disappear, with little to take its place. Formal knowledge is commonly promoted to young people but too often without providing the means to gain access to it Beyer, The study showed that the role of TMK in the past was very central to community health care and that it continues to be significant.

The interaction between traditional practitioners and the modern health system varied in the different places of the study area, with examples of close and uncomplicated cooperation in some places and little or no interaction in others. In both study areas, the THs generally stated that there are some signs of a new awareness and popularity of TMK, but the younger generation does not take TMK as seriously as the older generation and there is a need for concerted efforts for its promotion and youth involvement.

A central question during the interviews with practitioners was how young people will be taught in the future. During fieldwork, it was not uncommon that there were no trainees in the homesteads of THs. Many young people lack interest in learning TMK and do not approach them often, but in both study areas, there were TPs who had trainees who were positive and interested in learning.

If assistance were provided, a number of TPs mentioned that they would in the future be enabled to organize more training for the interested youth.

The youth who are receiving this TMK would be better equipped if combining TMK with modern medical knowledge and, as one interview person expressed it, might be able to improvise some of the ways in which they treat. The prevailing dominant scientific paradigm in school education is a context where few elements of TMK practices are permitted to surface Indigenous Knowledge and Peoples Knowledge IKAP , The youth, who migrate between these two knowledge systems, take action out of the predominant worldview, as seen in the study.

Tensions between the youth and elders emerge, knowledge is lost and undermined, while biodiversity is threatened and diminished. Some researchers argue that the increased migration of youth to urban centers denies the younger generation traditional community support systems, which include education in survival skills, communication skills, safety, and conflict prevention Ntuli, TMK is a result of experimentation and research, trial and error, providing room for innovative local knowledge learning in local practices and systems, even incorporating external knowledge based on different worldviews.

In both urban settings of the study area, TPs have established associations of TMK practitioners in which many of our interviewed persons were members. The major challenges revolve around their roles and relationships with the formal medical establishment as well as issues related to socio-spatial changes such as increased rural-urban migrations, and biodiversity loss.

Colonial structures are perceived to have been detrimental to the social dynamics of TMK as these structures negated traditional knowledge and subordinated it.

Despite this legacy, most TPs could see new roles of TPs and emphasized the promotion of TMK as a continued important aspect of community health in response to rapid socio-spatial changes and outmigration dynamics.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The studies involving human participants were reviewed and approved by Tanzania National Commission of Science and Technology.

Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

The author confirms being the sole contributor of this work and has approved it for publication. The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

The author acknowledges the contributions of all respondents including individuals from the fieldwork conducted as well as colleagues who contributed to the efforts of the author in reading. Andrzejewski, C. Does where you live influence what you know? Community effects on health knowledge in Ghana.

Health Place 15, — doi: PubMed Abstract CrossRef Full Text Google Scholar. Baimba, A. Battiste, M. Protecting Indigenous Knowledge and Heritage: A Global Challenge. Saskatoon, SK: Purich Publications. Google Scholar. Beyer, S. Singing to the Plants: A Guide to Mestizo Shamanism in the Upper Amazon.

Albuquerque, NM: University of New Mexico Press. Braun, V. Using thematic analysis in psychology. CrossRef Full Text Google Scholar. Cole, M. Cultural Psychology: A Once and Future Discipline.

Cambridge, MA: Harvard University Press. PubMed Abstract Google Scholar. Crossman, P. Odora Hoppers Claremont: New African Books , 96— De Bruijn, M. Mobile Africa, Changing Patterns of Movement in Africa and Beyond. Leiden: BRILL. Eyssartier, C. Cultural transmission of traditional knowledge in two populations of North Western Patagonia.

Ethno Med. French Institute for Research in Africa IFRA Geissler, P. Medicinal plants used by Luo mothers and children in Bondo district Kenya. Ethno Pharmacol. Hanks, R. Newman, and A. Hatton-Yeo Oxford: Oxford Institute of Ageing , 31— Helgesson, L.

Getting ready for life: life strategies of town youth in Mozambique and Tanzania Doctoral dissertation. CERUM Social and Economic Geography, Umeå University, Umeå. Hoff, A. Inter-generational Learning as an Adaptation Strategy in Aging Knowledge Societies. Warsaw: European Commission Education, Employment.

This included a submission by Japan that had been previously submitted to the WIPO Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore IGC. Parties to the CBD, WIPO and the WTO have considered the concept of a disclosure requirement in the patent system, put forward by its proponents as a means of ensuring that patents on inventions derived from TK and GR are consonant with the principles of PIC and EBS.

The proposals and the debate are diverse and cover areas other than medicine, although patents in the medical area have been the major focus of the debate. A number of countries have implemented such provisions in their national laws, but there is no agreed international standard.

An alliance of developing countries has proposed a revision to the TRIPS Agreement to make such provisions mandatory, 24 but other countries continue to question the usefulness and effectiveness of this kind of disclosure mechanism.

The cultural, scientific, environmental and economic importance of TK has led to calls for it to be preserved safeguarded against loss or dissipation and protected safeguarded against inappropriate or unauthorized use by others , and there are many programmes under way at national, regional and international levels to preserve, promote and protect different aspects of TK.

Such measures include: first, preserving the living cultural and social context of TK, and maintaining the customary framework for developing, passing on and governing access to TK; and second, preserving TK in a fixed form, such as when it is documented or recorded.

the protection against copying, adaptation and use by unauthorized parties. The objective, in short, is to ensure that the materials are not used wrongly. Two forms of protection — positive protection and defensive protection — have been developed and applied, as outlined above.

The IGC is working on the development of an international legal instrument for the effective protection of TK. It is also working on ways to address IP aspects of access to, and benefit-sharing of, genetic resources. The WTO TRIPS Council has also extensively debated the protection of TK, 26 including an African Group proposal for a formal decision to establish a system of TK protection, but this discussion has not led to any conclusions.

The IGC work on TK 27 is concentrating on positive protection and the IP aspect of protection — the recognition and exercise of rights to preclude others from illegitimate or unauthorised use of TK.

As WIPO member states are continuing efforts to negotiate on these issues, no final agreement has been reached. The text of an international legal instrument for the effective protection of TK is, therefore, in flux and new drafts continue to become available on a regular basis.

The information set out below seeks to provide a broad and informal description of the nature of the discussions under way in the WIPO negotiations. The IGC has considered the policy objectives for international protection, 28 including to:. There is as yet no accepted definition of TK at the international level.

In principle, TK refers to knowledge as such, in particular knowledge resulting from intellectual activity in a traditional context, and includes know- how, practices, skills and innovations.

It is generally accepted that protection should principally benefit TK holders themselves, including indigenous peoples and local communities. However, there is no agreement on whether families, nations, individuals and others such as the state itself could be beneficiaries.

While TK is generally regarded as collectively generated, preserved and transmitted, so that any rights and interests should vest in indigenous peoples and local communities, in some instances beneficiaries may also include recognized individuals within communities, such as certain traditional health practitioners with a specific reference to traditional medical knowledge.

Some countries do not use the term indigenous peoples or local communities and consider that individuals or families maintain TK.

One problem confronting TK holders is the commercial exploitation of their knowledge by others, which raises questions of legal protection of TK against unauthorized use, the role of PIC and the need for EBS.

TK holders also report lack of respect and appreciation for such knowledge. For example, when a traditional healer provides a mixture of herbs to cure a sickness, the healer may not isolate and describe certain chemical compounds and describe their effect on the body in the terms of modern biochemistry, but the healer has, in effect, based this medical treatment on generations of clinical experiments undertaken by healers in the past, and on a solid understanding of the interaction between the mixture and human physiology.

It is also a significant challenge to establish how protection under a national system could be enforced regionally and internationally. Existing IPRs have been successfully used to protect against some forms of misuse and misappropriation of aspects of TK.

Several countries have adapted existing IP systems to the needs of TK holders, including through specific rules or procedures to protect TK.

For example, the Chinese State Intellectual Property Office has a team of patent examiners specializing in TCM. Other countries have developed new, stand-alone sui generis systems to protect TK.

Peruvian Law No. The international legal instrument for the effective protection of TK, which is being negotiated in the IGC, is a sui generis system. Other options are also available, such as contract laws, biodiversity-related laws, and customary and indigenous laws and protocols.

Documentation is especially important because it is often the means by which people beyond the traditional circle get access to TK. It does not ensure legal protection for TK, which means that it does not prevent third parties from using TK.

I found it useful to try to find common thematic elements across the narratives and stories represented in the texts transcribed from the interviews and the events they reported. Major themes related to socio-spatial aspects of intergenerational learning processes were identified and analyzed within a relational understanding of migration in place and space.

Learning TMK includes obtaining proficiency in the identification, preparation, conservation, management, and administration of medicinal products. While rather few studies have looked at the importance of place and space or socio-spatial dimensions for medicinal learning processes, there are recent important contributions by Lindstrom and Muñoz-Franco , who studied the impact of outmigration on certain types of health knowledge, and other researchers who point out how place and social networks are crucial for health knowledge transmission Andrzejewski et al.

Through several generations, knowledge on the identification of plant species with medicinal properties and their use has been developed Sheldon and Balick, TMK learning is viewed as both temporal and spatial or place-based.

It relates to language, historical processes, and social relations which are largely influenced by political, economic, and social processes Hanks, In line with a relational understanding of social and spatial dimensions, intergenerational learning processes of medicinal knowledge are in this study understood as place-based and related to history, language, and social relations Geissler et al.

Some studies discuss prolepsis which takes a socio-cultural theoretical approach that conceptualizes the transmission of knowledge between generations where experiences are passed down and knowledge and values re-evaluated in the context of a rapidly changing world Cole, Studies on learning processes that are inter and intra-generational discuss processes that are co-constructed within relationships of mutuality and reciprocity Eyssartier et al.

Inter-generational relations and the priority accorded to seniority, which is at the core of social organization in Africa, have determined the modalities of learning processes of younger generations. Given the numeric importance and the heterogeneity of the young demographic group, these processes change relative to the social context French Institute for Research in Africa, Prince and Geissler describe how traditional medicinal knowledge among the Luo is usually imparted between alternate generations.

These skills are also seen to complement formal educational learning skills while invoking cultural continuity and change Kenner et al.

As is the case for the Luo in Kenya Sankan, ; Sindiga, and the Wasukuma of Tanzania, oral transfer of knowledge of ethnomedicine is also common in other ethnic groups in East Africa Ochieng' Obado et al.

Training to become a TH usually starts during the pre-adolescent age when the child is perceived as receptive, obedient, has a good memory, and can keep secrets Mwiturubani, Luo plant medicine has been argued to be mainly a domain of women's activity Olenja, but in general, in the study region, both men and women engage in TMK learning processes, while the three major forms of becoming a TH—inheritance, own illness, and calling—are not gender-specific.

Mejeke argues however that the present system of education in Africa emphasizes social and cultural contexts that are far removed from conceptual structures that are within African communities Majeke, A fundamental transformation with an aim of altering educational syllabi can be seen in what is described as mutual decolonization Crossman and Devisch, South Africa has developed an institutional model of TMK of the Sangomas THs.

Education within schools provides students with learning arenas where they graduate and are able to practice their profession as sangomas Thornton, Increased mobility and rural-urban migration by individuals to townships and cities in search of livelihoods and opportunities are similarly predominantly the case as socio-spatial transformations continue to evolve in the study area.

Similarities exist between the Luo and the Wasukuma in terms of historical migrations and TMK practices; the early Luo settlers in Kenya also had a pastoralist orientation. Male out-migrations from rural to urban areas have also been characteristic of this region and remittances from migratory wage labor provide important cash income for families left behind.

Rural-urban migrations involve social, economic, and cultural transformations, including changes in health practices and knowledge which will influence how TMK is perceived by the younger generation. Historically, traditional knowledge systems have been marginalized in relation to western systems Hoopers, ; Hountondji, ; Majeke, Although Colonial governments appreciated the existence of TMK alongside the introduced Western medicine, there was not much effort to promote this knowledge field.

Consequent efforts and official policy on TMK after independence have varied and there are important differences in formal and informal perceptions, practice, and policy on TMK between Kenya and Tanzania.

In Kenya, this sector is within the national culture and social services sector while in Tanzania it is within the health sector. The Kenyan and Tanzanian governments' policy for free primary education has provided incentives and opportunities for school attendance in both study areas, which also has led some TPs to promote the combination of TMK with formal primary education.

Learning processes occur that combined formal medical education in the urban area and then return to the rural area for training as a TP, thus young people are encouraged to become practitioners by way of combining the profession with formal medical studies.

Majeke puts forward that contents of syllabi emphasize the social and cultural rhythms of the early colonial settler communities with conceptual structures and categories of thought borrowed from European days of the past.

Colonial authorities taught and trained indigenous African students in schools and tertiary institutions in skills that did not fit them back into their communities, and that forced them to work in employment situations where foreign people's undertakings were situated.

Unlike the case of the institution of traditional healing of the sangoma in South Africa, where knowledge transmission takes place within schools from where students obtain membership and graduate as sangomas Thornton, , the learning processes by traditional practitioners in Kenya and Tanzania are not organized in a formal system of education in specific locations.

Traditional practitioners nevertheless have their professional networks, organizations, and meetings, for instance within the Traditional Practitioners Association in Homabay and Traditional practitioners Association in Mwanza.

Official documents in Kenya and Tanzania state that ongoing socio-spatial dynamics could be transforming the role of the THs in the study region see e. The empirical material showed a range of learning practices of practitioners, who worked mostly in their own houses and had their teaching organized spatially according to the location of plants and places of special significance.

The practitioners described the practical ways by which TMK is transferred gradually, over a long period of time and developed from the knowledge of one kind to different varieties and types of medicinal products.

The main approach of training is learning by doing in the home of the TH. The trainee repeats the different healing procedures until he or she is an expert, and it may for instance take years to remember the names of the numerous sometimes over different types of medicine:.

You see… in training for traditional native medicines, they say how come you have managed all diseases? Because you have sat on it for years… see this young boy, he has been here since he was a small boy and he is still in training male TH Magu.

While oral narrations are central in the training, THs place little importance on written information. One TH described how written information may even be less likely to be viable as enabling the transfer of knowledge than oral training:.

The 1,—2, trees I have planted… I tell them to go and pick the trees and when they come I show them which and which to mix together. That is how we teach those trainees.

If you keep it in the book, nothing! It will get lost male TH Magu. Resident trainees were more common in Magu, Tanzania than in Homabay Kenya and more often in the rural than urban settings.

Trainees who reside with the THs within the urban setting are most often though not always the direct offspring of the TH. When the trainee attends formal education, he or she goes to the TH's practice after school and undertakes further training during the school holidays.

THs expressed concern about rural-urban migration and changing livelihoods of the younger generation, which apart from less time for learning could lead to negative values and attitudes toward TMK:.

My son was taught by his grandmother's sister but he has left this work and does not attach value to it male TH Suba, Kenya. The young people are not vigilant and are not interested. They think it is old-fashioned and only prefer modern medicine female TH Rachuonyo, Kenya.

However, the interviews also showed that young people increasingly realized the income potential of traditional medicine through observations of the marketing of the products in the urban areas.

Traditional practitioners increasingly sell their products and provide their services in urban markets:. The youth are interested when they see that I have an income; I sell at the market in Homabay and at Rodi Kopany male TH Gem, Kenya.

The interviews showed that tougher socio-economic conditions both in rural and urban areas make it more difficult for TPs to provide housing for trainees, and, obviously, school attendance makes time more limited for a learning practice that takes many years even when it is continuous.

The importance of teaching indigenous knowledge to the youth was highlighted by the practitioners in both rural and urban settings, but they also stressed the challenges to TMK related to migration and rapid urbanization.

The trainee is sent to specific destinations to collect the products. Being sent is emphasized as crucial for obtaining the knowledge, but is also a form of payment from the trainee to the TH.

The trainee is regularly sent to the forest or bush to collect and harvest medicinal plants in order to bring them back to the homestead, which can be both time-consuming and tiring. First, if you want to know about work you should be a person's messenger.

She says, go and dig this medicine, you see this medicine… go and look for it and bring it to me… so you do it until you will know it female TH Gem. The TP shows the trainees the exact character of the medicines explaining what they cure.

Being sent and in-house repeated demonstration and practical work with patients are the ways the trainee receives the education. Without fees paid for the education, the trainees contribute as a form of payment to be sent to harvest the medicine, help on the farm, and provide other services within the homestead.

Is there any payment they give you? No, they do not pay me anything… so what benefits will you get from showing them? My interest is that I give them.

They acquire the legacy from me. I want them to acquire the knowledge from me male TH HB. According to the stories of the practitioners, the teaching, transfering, and processing of TMK today have both similarities and differences with the ways the older generation learned their practices.

Some major differences relate to the abundance of plants closer to the homestead in previous times. The geographical distances to places of harvest as well as to beneficiaries have increased, which means both that trainees have to be sent long distances and that new plant preservations techniques have developed:.

It is not different, but the style in which I use the medicine… is different from the old time, the system is different.

You know, the old people used to dig the medicine, put it in a pot and boil it, and then people drank it. I take the medicine, I pound it until it is very soft, soft… then I spread it in the sun and it dries and I use it in powder form.

It means that in powder form it can be used for a long time, you know, it can last longer while the boiled one has a short shelf life… female TH HB.

The youth today do not agree to be sent male TH Gem. The older TP's thus harvested, boiled the TM, and consumed it as a liquid or the boiled leaves. Today, the practitioners use drying and pounding techniques, which provide a longer shelf life and ease with transportation.

Increased migration to the urban centers, which are situated away from the locations where the medicinal products are harvested, has necessitated a change of preservation techniques to accommodate the longer shelf life of the products. The steady reduction in the availability of medicinal products together with the difficulty of sending trainees long distances also necessitates preservation.

Practitioners in both Mwanza and Nyanza described how the older generation used to cultivate TM close to the homestead to help in accessibility and teaching trainees and family members, combining gathering TM from the wild bush with planting them closer to the homestead.

Some of the younger TPs do cultivate plants close to the homestead, but informants also described how they had to seek permission and pay in order to be able to harvest from other clan lands.

Among the Luo, a man's plots are divided among his wives who if deceased pass them on to male children with the senior son receiving the largest portion Ochieng, With the socio-economic and socio-spatial changes, land allocation and accessibility have changed and land has become scarcer. When clan land gets overcrowded there is further migration to found new polities elsewhere Ochieng, This indirectly or directly influences harvesting and cultivation practices of traditional medicine and the empirical data revealed that this was particularly the case in the Nyanza context where scarcity of land is more apparent than in Mwanza.

Prayer and rituals form an important part of the trainees' education. Larger rituals are an integral part of a healer's work and they are carried out periodically bi-annually; every 3 years.

The knowledge of rituals is taught during the learning period and the specific ritual differs from person to person. Some ritual ceremonies use staple fodder and animal products milk, ghee, sorghum, and millet adorning a special dress code for all participants.

Almost always, a special tree has been chosen as the venue for the ritual ceremonies and these trees are usually situated hundreds of km away from the THs home place. These trees are often not available locally due to deforestation; the specific tree species are rare and often situated at long distances.

These sacred places are visited to acquire spiritual power, perform rituals, and collect medicines. As the tree is situated in another region there must be an agreement with the local village council to enable the visitors to carry out their work. The rituals and ceremonies in specific sacred places were a more important function in Mwanza than in Nyanza.

Due to increased migration dynamics in both contexts of younger populations moving to the urban places in search of alternative livelihoods, this form of training is becoming increasingly rare for the youth given the long distances to the ritual sites, which involves many days' travel.

Through the cure of a prolonged ailment, some chose to become practitioners themselves after a period of training with an older TH for up to 3 years. The suffering itself was then seen as part of and even a requisite for the learning process.

I was hurting. After I was healed I started to treat others one by one female TH, Magu. The research revealed that becoming a TP at a later age, sometimes through own illness, frequently took place outside the home area of the trainee, and often even outside the country of origin.

After graduation, a number of these trainees migrate back to their original homes and set up their own village hospitals. The latter was seen more often in Tanzania than in Kenya. We have given many who now have their own villages, more than 10 persons, they are now in Dar es Salaam, Musoma, Tarime… … and also Kenya male TH Magu.

Those who I am giving the system, they may in the future provide even better ways of treating and having a central role, perhaps they will be able to treat even better than I do, make TMK even have a bigger role, they may improvise Male TH 67 years.

Homabay, Kenya. The gift is supposed to be used to help cure ailments and societal problems. It is the duty of the traditional practitioner to act as a medium through which this gift is shared with individuals within the society who may need it, thus diffusion of the knowledge is central.

You see someone whose heart is good … You do not just give it to anyone… if you see someone who is hurting then you have sympathy for helping him… so then a lot of discoveries can come out of that medicine for you … female TBA Homabay. Those who I am giving the system, they may in the future provide even better ways of treating, they perhaps will be able to treat even better than I do, there may be improvising male TH HB.

TPs linked this negative knowledge diffusion to outmigration, with potentially negative effects on patients:. Adding someone's knowledge as it was added to me, I still find it difficult in one way. There was someone with a good idea and they took him and gave him a job.

Then it happened that he was sent away from the work. Then you know that those people have remained with all his ideas…and then they take the customers that you used to get male TH Gem. Many herbalists think the medicines which I have, they should also have, so they take them…at times they give wrong medicines and overdose them, which can injure people male TH HB.

The discussion on sorcery arises in the empirical data, particularly within the context of ethics and socio-cultural and socio-economic problems. In all interviews, this phenomenon was mentioned and vehemently criticized by the TPs and authorities. In the citations above, the fears were in particular related to the mobile younger generation's uses of TMK.

Dynamic changes in societal processes in the communities linked to migration and urbanization highlighted the role of parents, who sometimes feared and critiqued the TP's work:. Parents think it is negative and they have fear male TH Gem.

Some fear and accuse the young people of learning how to bewitch and kill people… male TH Gem. The family and household need to have a consensus on if the TMK can be taught to the youth female TH Gem.

Some of the TPs who were interviewed had future plans to expand premises for patients both in rural and urban areas. In particular in Tanzania, commonly mentioned were plans to cultivate medicinal plants on land already purchased and acquired for this purpose.

Some TPs saw the way forward in finding new ways of combining TMK learning with formal education, thus bridging rural practices with urban educational and market opportunities.

While expressing concerns about the future generations, many respondents nevertheless stressed that youth are interested and wish to practice as TPs.

We found learning processes that combined formal medical education with TMK, and some traditional practitioners, who themselves had formal western education, encouraged their offspring to complete their education before pursuing work with traditional medicine.

Are the youth interested in learning about traditional medicine? Very much. The moment they learn this they want to continue…I say they should finish school first, and to those who have finished, I teach the treatment male TH HB.

There is another one who tried to read, and recently went to the college of medicine. Now he has finished and is at home… you see he has inherited male TH HB. I used to teach both modern medicine and traditional medicine.

People come and I also refer to the hospital. Every 2 days they come and I give advice male TH, Suba. In our study area, we found several cases of medical pluralism We understand medical pluralism as the consultation of both traditional and western medical practices.

Some Wasukuma practitioners explicitly recognized the benefits of modern medicine, and several of our respondents suggested that there are certain ailments that only a traditional healer can cure, yet there are other sicknesses that a modern hospital can more readily heal with technologies such as intravenous fluids and store-bought medicines.

Pragmatic considerations were common, but forms of true cooperation between the two systems were rare. The interactions between traditional and modern health systems were related to rural—urban inequalities and did not take place without complications.

We found only a few cases of close cooperation between practitioners and modern health systems, such as when the TP referred his patients to hospitals, and one practitioner received patients from the hospitals and organized a transportation system to facilitate the interaction between his village and the urban hospital.

The growing disenchantment with farming as a way of life has made young rural based people in both Mwanza and Nyanza to migrate and actively diversify into non-agricultural activities. Rural-based TMK is not perceived as a viable long term livelihood strategy for the younger generation, but some traditional practitioners envisioned a strategy for young people to become practitioners by way of combining formal medical studies in the urban area and then return to the rural area for training as a TP.

Two respondents had sons who were attending urban formal education and intended to complete it before continuing working with traditional medicine in the rural setting.

Another respondent's son, who was 18 years old, had decided to become a doctor in formal medicine and thereafter practice as a traditional healer. TPs testified that it has become more common that younger TPs are trained in both systems.

The younger populations attribute lower value to TMK which indicates rising challenges of TMK and its transmission to further generations of TPs.

With the introduction of formal western education during the colonial and postcolonial eras, there was a disdain for traditional knowledge, and children were expected to abandon previous learning systems Miller, Despite the continued use and importance of TMK, this legacy contributes to prevailing negative perceptions and suspicions about learning TMK.

The traditional practitioners interviewed in this study described how environmental pressure, migration of the youth, and socio-spatial changes in the study area over the last three decades have created new challenges for TMK practices.

Some were concerned about negative values about TMK in the younger generation, while others stressed the will of young people to engage in training and become practitioners.

The youth's keen interest to learn was seen to increase when they viewed improved livelihood possibilities of THs due to the commercialization of medicinal plants, especially in the outmigration spaces.

Some of the interviewed practitioners pointed out the missing link between TMK learning processes and the formal education system. Our study showed a strong influence of modern education in affecting the perceptions and access of the youth to TMK. With this opportunity, the youth who migrate to attend modern education have limited time if any to learn TMK.

The future of TMK learning processes may be limited unless incentives are in place for the youth, regarding their future livelihoods. Odore argues that in Africa, colonial science and education are knowledge on Africa. The problem today is how to make it knowledge by Africans for their own collective promotion and development.

The Wasukuma and Luo's youth livelihoods are increasingly merging into circumstances that place a lower value on their traditional medicinal knowledge. Under this pressure, traditional knowledge of medicinal plants is starting to disappear, with little to take its place.

Formal knowledge is commonly promoted to young people but too often without providing the means to gain access to it Beyer, The study showed that the role of TMK in the past was very central to community health care and that it continues to be significant.

The interaction between traditional practitioners and the modern health system varied in the different places of the study area, with examples of close and uncomplicated cooperation in some places and little or no interaction in others.

In both study areas, the THs generally stated that there are some signs of a new awareness and popularity of TMK, but the younger generation does not take TMK as seriously as the older generation and there is a need for concerted efforts for its promotion and youth involvement.

A central question during the interviews with practitioners was how young people will be taught in the future. During fieldwork, it was not uncommon that there were no trainees in the homesteads of THs.

Many young people lack interest in learning TMK and do not approach them often, but in both study areas, there were TPs who had trainees who were positive and interested in learning. If assistance were provided, a number of TPs mentioned that they would in the future be enabled to organize more training for the interested youth.

The youth who are receiving this TMK would be better equipped if combining TMK with modern medical knowledge and, as one interview person expressed it, might be able to improvise some of the ways in which they treat.

The prevailing dominant scientific paradigm in school education is a context where few elements of TMK practices are permitted to surface Indigenous Knowledge and Peoples Knowledge IKAP , The youth, who migrate between these two knowledge systems, take action out of the predominant worldview, as seen in the study.

Tensions between the youth and elders emerge, knowledge is lost and undermined, while biodiversity is threatened and diminished. Some researchers argue that the increased migration of youth to urban centers denies the younger generation traditional community support systems, which include education in survival skills, communication skills, safety, and conflict prevention Ntuli, TMK is a result of experimentation and research, trial and error, providing room for innovative local knowledge learning in local practices and systems, even incorporating external knowledge based on different worldviews.

In both urban settings of the study area, TPs have established associations of TMK practitioners in which many of our interviewed persons were members.

The major challenges revolve around their roles and relationships with the formal medical establishment as well as issues related to socio-spatial changes such as increased rural-urban migrations, and biodiversity loss.

Colonial structures are perceived to have been detrimental to the social dynamics of TMK as these structures negated traditional knowledge and subordinated it.

Despite this legacy, most TPs could see new roles of TPs and emphasized the promotion of TMK as a continued important aspect of community health in response to rapid socio-spatial changes and outmigration dynamics.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The studies involving human participants were reviewed and approved by Tanzania National Commission of Science and Technology.

Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

The author confirms being the sole contributor of this work and has approved it for publication. The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.

Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. The author acknowledges the contributions of all respondents including individuals from the fieldwork conducted as well as colleagues who contributed to the efforts of the author in reading.

Andrzejewski, C. Does where you live influence what you know? Community effects on health knowledge in Ghana.

Health Place 15, — doi: PubMed Abstract CrossRef Full Text Google Scholar. Baimba, A. Battiste, M. It may apply to traditional medicines as such, or to knowledge systems relating to medical treatment such as healing massage or yoga postures.

Traditional medicine systems can be categorized as follows: The past decade has seen greater attention paid to traditional medical knowledge in several international policy contexts. The high prevalence of traditional medicines throughout the world, coupled with efforts to integrate traditional medicines in modern national health systems, has increased the demand for information on the safety, efficacy and quality of these medicines.

The regulation of traditional medicines takes many different forms around the world. Depending on the national legislative and regulatory framework, they can be sold as prescription or non- prescription medicines, dietary supplements, health foods or functional foods.

Additionally, the regulatory status of a particular product may differ in different countries. The same herbal product can be considered differently if it is traded between two countries which have different regulatory approaches and requirements.

Herbal products which are categorized as something other than medicines and foods are becoming increasingly popular, and there is potential for adverse reactions due to lack of regulation, weaker quality control systems and loose distribution channels including mail order and Internet sales WHO, a.

In , the International Regulatory Cooperation for Herbal Medicines IRCH , a global network of regulatory authorities responsible for the regulation of herbal medicines which operates in conjunction with the WHO, was established.

Its mission is to protect and promote public health and safety through improved regulation of herbal medicines. Currently, over WHO member states regulate herbal medicines. To support the efforts of member states in establishing and implementing effective regulation of herbal medicines, the WHO has published key global technical guidelines, in terms of their quality, safety and efficacy and sustainable use.

Several other sets of guidelines are in development, including guidelines on the assessment of herbal medicines, the methodology for research and evaluation of traditional medicine, good manufacturing practices GMPs for herbal medicines as well as conservation and sustainable use of medicinal plants, such as good agricultural and collection practices GACP for medicinal plants.

In addition, the WHO has developed a series of volumes of WHO monographs on selected medicinal plants, which aim to provide scientific information on the safety, efficacy and quality control of widely used medicinal plants.

The WHO provides models to assist member states in developing their own monographs or formularies for these and other herbal medicines, and it also facilitates information exchange among member states. Growth in international trade in traditional medical products has sparked discussions on the trade impact of regulations.

In recent years, WTO members have notified the WTO Committee on Technical Barriers to Trade TBT Committee in relation to a range of regulations that have a direct bearing on traditional herbal medicines. Such regulations include: GMPs for the production of herbal remedies Mexico ; regulation of herbal medicines for the protection of public health Peru ; inspection of herbal medicines for the protection of consumers and the promotion of public health Republic of Korea ; and regulations on the preparation of herbal medicine for human consumption Kenya.

Research is continuing on traditional medicines and traditional medical knowledge in various different areas, each generating a multitude of policy issues:. The use of genetic resources GR and associated TK is primarily regulated by the Convention on Biological Diversity CBD and the Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization to the Convention on Biological Diversity Nagoya Protocol.

National biodiversity policies frequently reference traditional medicines and medical research. The essential effect of the CBD and the Nagoya Protocol is to confirm national sovereignty over GR and to establish a right of prior informed consent PIC , approval and involvement, over the access to, and use of, associated TK.

Many of the issues highlighted in this debate concern genetic materials used as the basis for medical research, and traditional medical knowledge that is either used directly to produce new products or is used as a lead in researching new treatments.

The Commission on Intellectual Property Rights, Innovation and Public Health CIPIH has called for benefits derived from TK to be shared with the respective communities WHO, b.

How to apply PIC and equitable benefit sharing EBS has sparked a wide-ranging debate. Concerns about improving patent examination in the TK area, in order to avoid erroneous patents on traditional medicines in particular, have led to initiatives at international and national levels.

A leading example is the Traditional Knowledge Digital Library TKDL , a collaborative project in India between the Council of Scientific and Industrial Research CSIR , the Ministry of Science and Technology, and the Ministry of Health and Family Welfare. An interdisciplinary team of Indian medicine experts, patent examiners, information technology experts, scientists and technical officers have created a digitized system enabling consultation of existing literature in the public domain relating to Ayurveda, Unani, Siddha and Yoga.

Such literature is generally available in traditional languages and formats. The TKDL therefore provides information on traditional medical knowledge in five international languages and formats which are understandable by patent examiners at international patent offices. The aim is to prevent the grant of erroneous patents, 21 while at the same time not newly publishing TK in a way that would facilitate its misappropriation.

The WHO GSPA-PHI urges governments and concerned communities to facilitate access to traditional medicinal knowledge information for use as prior art 22 in the patent examination procedures, where appropriate, through the inclusion of such information in digital libraries Element 5. The WTO TRIPS Council has discussed how to preclude erroneous patents using GRs and associated TK through the use of databases.

This included a submission by Japan that had been previously submitted to the WIPO Intergovernmental Committee on Intellectual Property and Genetic Resources, Traditional Knowledge and Folklore IGC.

Parties to the CBD, WIPO and the WTO have considered the concept of a disclosure requirement in the patent system, put forward by its proponents as a means of ensuring that patents on inventions derived from TK and GR are consonant with the principles of PIC and EBS.

The proposals and the debate are diverse and cover areas other than medicine, although patents in the medical area have been the major focus of the debate. A number of countries have implemented such provisions in their national laws, but there is no agreed international standard.

An alliance of developing countries has proposed a revision to the TRIPS Agreement to make such provisions mandatory, 24 but other countries continue to question the usefulness and effectiveness of this kind of disclosure mechanism.

The cultural, scientific, environmental and economic importance of TK has led to calls for it to be preserved safeguarded against loss or dissipation and protected safeguarded against inappropriate or unauthorized use by others , and there are many programmes under way at national, regional and international levels to preserve, promote and protect different aspects of TK.

Such measures include: first, preserving the living cultural and social context of TK, and maintaining the customary framework for developing, passing on and governing access to TK; and second, preserving TK in a fixed form, such as when it is documented or recorded.

the protection against copying, adaptation and use by unauthorized parties. The objective, in short, is to ensure that the materials are not used wrongly. Two forms of protection — positive protection and defensive protection — have been developed and applied, as outlined above.

The IGC is working on the development of an international legal instrument for the effective protection of TK. It is also working on ways to address IP aspects of access to, and benefit-sharing of, genetic resources.

The WTO TRIPS Council has also extensively debated the protection of TK, 26 including an African Group proposal for a formal decision to establish a system of TK protection, but this discussion has not led to any conclusions.

The IGC work on TK 27 is concentrating on positive protection and the IP aspect of protection — the recognition and exercise of rights to preclude others from illegitimate or unauthorised use of TK.

As WIPO member states are continuing efforts to negotiate on these issues, no final agreement has been reached. The text of an international legal instrument for the effective protection of TK is, therefore, in flux and new drafts continue to become available on a regular basis.

The information set out below seeks to provide a broad and informal description of the nature of the discussions under way in the WIPO negotiations.

The IGC has considered the policy objectives for international protection, 28 including to:. There is as yet no accepted definition of TK at the international level. In principle, TK refers to knowledge as such, in particular knowledge resulting from intellectual activity in a traditional context, and includes know- how, practices, skills and innovations.

It is generally accepted that protection should principally benefit TK holders themselves, including indigenous peoples and local communities. However, there is no agreement on whether families, nations, individuals and others such as the state itself could be beneficiaries.