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DIAGNOSIS AND TREATMENT OF ÀMÓDI IN IFÁ DIVINATION AMONG THE YORUBA OF SOUTH WESTERN NIGERIA
By
Paul Akinmayowa AKIN-OTIKO
B. A. , M. A. Philosophy (University of Ibadan) Matric. No. 131462
A THESIS IN AFRICAN BELIEF SYSTEM SUBMITTED TO THE INSTITUTE OF AFRICAN STUDIES, IN PARTIAL FULFILMENT OF
THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY OF THE UNIVERSITY OF IBADAN
FEBRUARY, 2013
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CERTIFICATION
I certify that this thesis which has been read and approved as meeting the requirement for the award of the Doctor of Philosophy in African Belief System, Institute of African Studies, University of Ibadan, was carried out by Paul Akinmayowa AKIN-OTIKO under my supervision at the Institute of African Studies, University of Ibadan, Nigeria.
__________________ _________________________
Date
Charles Obafemi JEGEDE
B.A., M.A., Ph.D (University of Ibadan)
Senior Research fellow
Institute of African Studies
University of Ibadan
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DEDICATION
This work is dedicated first to Olódùmarè, Olú onísègùn gbogbo and to all who have
shown and are showing sincere concern for human healthcare.
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ACKNOWLEDGEMENT
I must begin by thanking Olódùmarè, who inspired this research and provided the field, the data and the capability to begin and come this far with the work. I am grateful to my Provincial, Rev. Fr. C. Ukwe, OP and all the members of the Dominican Province of St.
Joseph the Worker, Nigeria and Ghana, your encouragement is immeasurable. To the members of my family, you could not have been more supportive. I appreciate my late Father, Baba Akinlolú-omo Otiko, who conceived the idea of this research with me, your memory kept the work going, and the risks I must say, were worth taking. To my wonderful siblings and in-laws, I will be saying the least to say we all worked hard at this research. I really appreciate you all, may God and destiny that have brought us together, keep us all together happily.
To all my friends who stood strong by my in the course of this research, I cannot mention you all, know that I do really appreciate you. My friend and brother Rev. Fr. E. Owoeye, you were just splendid, I could not have had a more comfortable stay on the campus without your support. I am grateful to Dr. J. Igbeka, who gave me the required access to the library from the beginning of this research, you made this work smooth. To the Chinedu Idigo family, thank you for the unalloyed support, may God reward you.
To my amiable supervisor, Dr. C. O. Jegede, you are one that every researcher would want to have. You were a mentor and support from the beginning to the end. I owe this work to your expertise, e sé o! aó ma rí yin bá. To my Olúwo, Baba-awo, Ifasesan Ojekunle, who accepted me as his student, your support is invaluable. To the members of the Faculty, Institute of African studies, I must confess that the support and critique this research received from you, gave it the quality and outlook it has, for this, I am very grateful to you all.
I cannot adequately express my gratitude to Kirche in Not/Ostpriesterhilfe and Prof V.
Asor, who sponsored this research. Your support made this expensive research possible within specified time.
Paul Akinmayowa AKIN-OTIKO
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TABLE OF CONTENTS
Title Page
Certification i
Dedication ii
Acknowledgement iii
Table of Content iv
List of Tables vii
List of Plates viii
Lists of Maps ix
Abstract x
CHAPTER ONE: GENERAL INTRODUCTION
1.1 Background to the Study 1
1.2 Statement of Problem 4
1.3 Aim and Objectives of the Study 5
1.4 Scope and Limitations of the Study 7
1.5 Problems of Data Collection 8
1.6 Significance of the Study 12
1.7 Description of Concepts 12
1.7.1 Diagnosis in Ifá Divination 12
1.7.2 Disease and Disease Aetiology in Yoruba Traditional Medicine 13
1.7.3 Ifá Divination Among the Yoruba 14
1.7.4 Àmódi (Somatoform Disorders) 15
CHAPTER TWO: LITERATURE REVIEW AND THEORETICAL FRAMEWORK
2.0 Introduction 17
2.1 Diagnosis and Treatment of Diseases in Western Medical Practice 17
2.2 African Traditional Medicine (ATM) 18 16
2.3.1 Yoruba Traditional Medicine (YTM) 21
2.3.2 The Concept of Incurability àrùn tí ò seé wò 26
2.3.3 Disease Aetiology in Yoruba Traditional Medicine 29
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2.3.4 Diagnosis in Yoruba Traditional Medicine 35
2.4 Ifá Divination as a Method of Diagnosis 41
2.4.1 Processes of Ifá Divination 47
2.5 Somatoform Disorder 49
2.5.1 Classification of Somatoform Disorder in Western Medical Tradition 54
2.5.2 Somatoform Disorder in Different Cultures 56
2.5.3 Treatment of Somatoform Disorders in Western Medical Tradition 57
2.6 Gap in Knowledge 61
CHAPTER THREE: RESEARCH METHODOLOGY
3.0 Introduction 63
3.1 Data Collection 63
3.2 Research Techniques and Instruments 68
3.2.1 Pre-field 68
3.3.2 Fieldwork 68
3.3.2.1 Participant Observation 68
3.3.2.2 In-depth Interview 70
3.3.2.3 Focus Group Discussions (FGDs) 73
3.3.3 Post-field 73
3.4 Method of Data Analysis 73 64
3.5 Theoretical Framework 80
3.5.1 Ethno-science as a Theory 81
3.5.2 Phenomenology as a Theory 83
CHAPTER FOUR: AMODI IN THE PRACTICE OF IFÁ DIVINATION: DATA ANALYSIS
4.0 Introduction 85
4.1. Àmódi in the Understanding of the Babaláwo 85
4.2 Àmódi and Disease Aetiology in Ifá Divination 91
4.3 Classification of Àmódi 114
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4.3.1 Difficulty in Classifying Àmódi Using Manifested Symptoms 114 4.3.2 Difficulty in Classifying Àmódi Using Disease Aetiologies 117 4.3.3 One Disease Aetiology Manifesting in Different Symptoms 120 4.3.4 Analysis and Grouping of the Found Disease Aetiologies 122
4.4 Preventive and Treatment Methods of Àmódi 122
4.4.1 Preventive Treatments 124
4.4.2 Curative Treatments 131
4.4.3 Analysis of the Treatment forÀmódi 138
4.4.4 Possible Problem in the Treatment of Àmódi 139
4.5 Efficacy of Ifá Divination on Àmódi 141
4.5.1 Disposition of Patients to Visit Babaláwo 142
4.6 Disposition of Babaláwo to Patients withÀmódi 143
4.7 The Effectiveness of Ifá Divination in the Treatment Process of Àmódi 145
CHAPTER FIVE: SUMMARY AND CONCLUSION
5.1 Summary 148
5.2 Recommendations 151
5.3 Conclusion 152
BIBLIOGRAPHY 155
APPENDICES
Appendix One Oral Sources of Data through In-dept Interviews
And FGDs 174
Appendix Two Cases, Diagnoses And Prescriptions Of Observed Patients 175
Appendix Three Questions Used During FGDs 220
Appendix Four Field-Work Guide 221
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LIST OF TABLES
Table 4.1: Demographic Table of the Observed Patients 91 Table 4.2: Group One, Patients with a Condition Traced to Òrìsà (deity) 93 Table 4.3: Group Two, Patients with Conditions Traced to Èèwọ (taboo) 97 Table 4.4: Group Three, Patients with Conditions Traced to Orí (one‘s
personality soul) 101
Table 4.5: Group Four, Patients with Conditions Traced to Ìwà-búburú (bad
character) 104
Table 4.6: Group Five, Patients with Conditions Traced to Ayé/Àjẹ (witches) 107 Table 4.7: Group Six, Patients with Conditions Traced to Àì-kò-béèrè (lack of
divination) 111
Table 4.8: Group Seven, Patients with Conditions Traced to Ìrírí Ayé (life
experience) 112
Table 4.9: Same Symptom with Different Disease Aetiologies 115
Table 4.10: Different Disease Aetiologies Manifesting in the Same Symptom 118
Table 4.11: One Disease Aetiology Manifesting in Diverse Symptoms 121
Table 4.12: Willingness and Awareness of Patients‘ to Use Ifá Divination 141
Table 4.13: Effectiveness of Ifá Divination in Treating Àmódi 146
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LIST OF PLATES
Plate 1: pẹ lẹ , Ìbò and Ìróké, Divination Tools 41
Plate 2: Ikin-Ifa (16 Sacred Palm-Nut) 42
Plate 3: Ifasesan Ojekunle (Babaláwo) Attending to a Patient 43 Plate 4: Awo Atunbi Ifá in the Process of Divining for a Patient 49 Plate 5: Awolowo Awogbile (first) in his health centre with Akintayo
Ifawuyi (second from left), Ifalowo Awogbile (third from left) and Ojoawo Awogbile (last).
They are all babaláwo practicing in and around Osogbo. 65 Plate 6: Ifasesan and his father (Ifalambe Ojekunle) who both practice as
Babaláwo in Ibadan. 72
Plate 7: Ifatayo Awogbile (middle) and his son Ifalowo (right) who are
babaláwo in Oșogbo. 73
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LIST OF MAPS
Map 1: Map of Nigeria showing the six Geo-political zones, the
36 States and the Federal Capital Territory (FCT). 66 Map 2: The towns (Abeokuta, Akure, Ibadan & Osogbo),
South Western Nigeria, showing the scope of study. 67
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ABSTRACT
Diagnosis in Ifá therapeutic practice makes a distinction between àìsàn ara(physical disease) - conditions that are diagnosable and treatable, and àmódi (somatoform disorders) - conditions that are not diagnosable and treatable using Western medicine.
Studies in Ifá therapeutic practice have placed emphasis on àìsàn ara, while the diagnosis and treatment of àmódi have not been adequately addressed. This study, therefore, examines how àmódi is diagnosed and treated in Yoruba traditional medicine.
Boas‘ theory of Ethno-science and Husserl‘s theory of Phenomenology were used to situate Ifá divination as a Yoruba therapeutic system. Using In-depth-Interviews (IDI), data were collected on the methods of diagnosis and treatment from 40 babaláwo (Ifá priests and healers) using snowball technique and 100 patients on their health conditions across Abeokuta, Akure, Ibadan and Osogbo, where there are state owned hospitals.
Twenty-three àmódi patients who were informally referred from hospitals, were purposively selected from 100 patients, and with the use of Participant Observation method, the processes of diagnosing and treating these patients were observed, this varied from one day to six months post-treatment. Case-study model was used to group data, and they were assigned into categories. Data were content analysed.
Ifá dídá (divination) diagnosed àmódi by revealing the disease aetiologies and
prescriptions contained in Odù-ifá (Ifá verses). Ikin (sacred palm nuts)and ọ pẹ lẹ (divining
chain)served as primary diagnostic tools, while obì (kola nut), owó ẹyo (cowries) and
egungun (animal bone) were used as secondary diagnostic tools. Àmódi was difficult to
diagnose using Western tools because it manifested similar symptoms as àìsàn ara. The
causes of àmódi were however located in Odù-ifá. Symptoms of àmódi had no regular
pattern, one type of symptom (inú-kíkùn - stomach upset), resulted from multiple
causations such as Ìjà Èsù (attack from Èsù),Èèwọ (taboo), Orí (personality soul), just as
one causation (Èèwọ ), presented multiple symptoms such as, oríitúlu (migraine), egbò-
àdáàjiná (skin ulcer), inú-kíkùn. The causes of àmódi include: Ìjà Èsù (as found in one
patient), Èèwọ (as found in four patients), Orí (as found in four patients), Ìwà búburú
(bad character, such as ‗olè-jíjà - stealing‘, ‗àgbèrè - adultery‘, as found in seven
patients), Àjẹ (witches, as found in four patients), Àì-kò-béèrè (lack of divination and Àjẹ
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were found in one patient) and Ìrírí ayé (life experiences, as found in three patients).
Observed, treatments were in three stages and were referred to as siblings. Ẹbọ l‟ ẹ gbọ n (sacrifice being the oldest),treated the spiritual and psychological aspects of the patients.
Òògùn/àkóse-ifál‟àbúrò (medicine being younger),treated the physical aspects of the patients. And gbọ n-inú l‟ọmọ iyèkan wọn lénjẹ lénjẹ, (inspiration being the youngest), complemented the other two. All the 23 patients confirmed full recovery. Besides each patient‘s testimony of wellness, final divination - Ó tán nb‟ókù? (Is this all or there is more?), was used as confirmatory tests.
Ifá divination is a formidable diagnostic and treatment tool among the Yoruba of South Western Nigeria. Its ability to distinguish between similar symptoms of àìsàn ara and àmódi transcends the practice in Western medicine.
Key words: Àmódi,Babaláwo, Diagnosis, Ifá divination, Treatment
Word count: 499
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CHAPTER ONE
GENERAL INTRODUCTION
1.1 Background to the Study
Discussions about healthcare concerns can generally spread across diseases aetiologies, particular diagnosis and treatment of cases. The understanding of disease aetiologies helps healthcare providers prevent diseases and where it becomes impossible to prevent, they are able to diagnose particular conditions given the understood disease aetiologies. With the possibility of diagnosis, treatment becomes possible.
Lack of understanding of disease aetiologies makes it impossible to diagnosis and treat diseases. Difficult diagnosis has been a serious challenge to the competence of healthcare providers. This leaves healthcare providers with no clue of treatment procedure to follow.
Diagnosis of diseases and conditions has been known to be a tedious and important task in the practice of medicine. Tedious because diseases vary and can present different symptoms making it difficult for healthcare providers to be precise in many of their diagnosis. It is important because without it, treatment cannot commence. Western medicine is daily advancing and developing methods of diagnosis, but in the midst of this development, there are still many diseases and conditions that Western methods cannot diagnose.
The difficult faced in diagnosing every disease and condition has made it imperative to recognise and examine different healthcare paradigms. WHO has recognised and aligned with traditional medicine because ―the biomedical (or Western system of medicine) which is popularized by governments, cannot cope with current morbidity and mortality rates‖ (Sindiga, 1995:1).
There is the need to integrate all possible indigenous knowledge that can provide or contribute to holistic healthcare. Indigenous or traditional medicine refers to ―the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.‖ (WHO, 1978)
In 1978 at the Alma Ata International conference on Primary Health Care, WHO considered health in its broad concept of physical, mental and social well-being. It noted that traditional practices constitute a major influence on the health of the individual and of the community (WHO, 1978). Akerele (1987) observed that the recognition of the value of African Traditional Medicine (ATM) has led to the attempts to encourage its use especially in the developing countries.
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The Alma Ata International conference on Primary Health Care is regarded as the loud voice or advocate for traditional healthcare. This is because in attendance at this conference, were representatives of 134 countries and 64 United Nations (UN) agencies. The conference clearly declared health a universal human right issue and urged governments of all member nations to provide accessible, affordable and socially relevant healthcare to each individual by the year 2000 (Golladay and Liese, 1980).
The resolution of WHO was reiterated at the World Health Assembly (WHA) held in 1987 (Nakajima, 1987). This was done because traditional healthcare practices are more widely employed in developing countries where health facilities and health education are still beyond the reach of the majority of the people. In many parts of Africa, for example, it is estimated that about 90% of the population rely on traditional healers (WHO, 1978).
Today, the observed patronage of ATM has not decreased, WHO gave a breakdown of observed patronage in Africa, Asia and Latin America as follows: in Africa, up to 80% of the population use traditional medicine for primary healthcare, 30%-50% of traditional herbal preparations account for the total medicine consumption in China, whilst in Ghana, Mali, Nigeria and Zambia, the first line of treatment for 60% of children with high fever resulting from malaria is the use of herbal medicine at home (WHO 2003b).
The interest of WHO in traditional medicine indicates the awareness of broad disease aetiology and the possibility of different methods of diagnosis in ATM. This awareness gives a background to the problem of this study. There is a broad disease aetiology in Africa and there are many diseases that are either difficult to diagnose or not diagnosable at all (somatoform disorder or àmódi as the Yoruba people will refer to it) when Western method of healthcare is employed.
Given this awareness, one asks: can Ifá divination (African traditional method of diagnosis) help to resolve the diagnostic puzzles surrounding the cases of àmódi especially when Western methods of diagnosis have proven useless?
The importance of diagnosis is manifest in the expanded medical diagnostic tools found among the Yoruba traditional healers of South Western Nigeria. A traditional healer uses
plant, animal, and mineral substances and certain other methods. These methods are based on social, cultural, and religious backgrounds as well as on the knowledge, attitude, and beliefs that are prevalent in community regarding physical, mental, and social well-being and causes of diseases and disability (Sofowora, 2008:1).
Discoursions in traditional medicine have become popular as different cultures are evolving different methods of healthcare that are believed to be best suited for particular diseases. This development has been
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observed and adjudged praiseworthy by World Health Organization (WHO). This study builds on the background that ATM has somethings to offer the world of healthcare by complementing the developments in Western medicine.
Is the use of Ifa divination in the diagnosis and treatment of àmódi (conditions that are not diagnosable and treatable using Western medicine) a possible complementing effort?
This concern becomes central to this study because for the practitioners of Yoruba traditional medicine, there are no àrùn tí ò sé é wò (incurable diseases). This claim is based on the use of both physical and non- physical methods of diagnosis and the knowledge of disease aetiologies beyond the limits of Western healthcare practices. It is believed that as soon as the cause of a disease is known, the relevant treatment becomes achievable. The psychosomatic nature of the Yoruba people, prevents them from acceptig that there is anything like àrùn tí ò sé é wò (incurable disease). A disease becomes incurable only because it is located within the realm of material and sensual realities alone.
1.2 Statement of Problem
The need for healthcare compels humans to search for diagnosis in order to bring about the treatment of emerging diseases and conditions. There are diseases and conditions that are diagnosable and treatable (àìsàn ara), just as there are some other conditions that are not diagnosable and therefore not treatable (àmódi - conditions that are not understood and so not diagnosable and treatable using Western medicine).
Studies abound in the area of diseases that are diagnosable and treatable. Symptomatic patterns of diagnosable diseases have been linked to effective treatment procedures over the years. There are established treatment procedures in response to the occurrence of particular symptoms of àìsàn ara, such that symptoms can be easily linked to understood disease aetiologies.
Àmódi, on the other hand, has been linked to disease aetiologies, such as witches, breaking of taboos, exhibiting bad behaviour, etc. that are culturally understood. These conditions do not have fixed patterns of occurrence or symptoms, thereby making diagnosis difficult. The difficulty in diagnosing àmódi with the use of Western diagnostic tools has created a quest for an alternative.
Although àmódi has been linked to culturally understood disease aetiology, there has not been a systematic attempt to examine the link between culturally understood disease aetiologies and symptoms and why it is not possible to diagnose àmódi using Western healthcare tools.
Previous studies have relied heavily on the use of Western healthcare diagnostic tools without much success. This study therefore examined the possibility of using Ifá divination as a diagnostic and treatment
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tool for àmódi - conditions that Western healthcare does not understand and so cannot respond to - because Ifá divination is known to be an ancient reliable medical system.
Patients patronise Yoruba traditional medicine as a result of habit or preference, lack of information and education, low economic power, lack of access to Western healthcare and religious beliefs among other reasons. But beyond these reasons, this study focused on the diagnosis and treatment of àmódi, because patients resort to the use of Ifá divination as ‗the last option‘, that is, because all attempts at the use of Western medicine have proven helpless.
The reality of àmódi and the failure of Western medicine to diagnose and treat àmódi makes it imperative to seek potent healthcare methods that are available, affordable, accessible and effective.
Can Ifá divination raise up to this challenge?
What does Ifá divination do that Western medicine cannot do?
And why does àmódi poses so much difficulty to Western medicine?
1.3 Aim and Objectives of the Study Aim:
The reality of patients‘ suffering and pain as a result of àmódi cannot but make one desire a solution to this problem even though Lipowski (1987) has highlighted it as ‗medicine‘s unresolved problem‘. This study aimed to broaden the current classifications of àmódi from the current Western limited scope, to include cultural realities and beliefs, and attempted to examine possible social cultural causes of àmódi among the Yoruba with a view to examine the possibility of diagnosing and treating them using Ifá divination.
Research Objectives:
This study sets out to examine:
what Western medicine and YTM refer to as àmódi.
the processes of Ifá divination in relation to the diagnosis and treatment of àmódi.
the need for the patronage of Ifá divination as a reliable method of diagnosis for àmódi.
the place of Ifá divination in the process of the diagnosis and treatment of àmódi.
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and gather some of the experiences of patients that have being diagnosed with àmódi in order to understand and expand the classification of àmódi.
whether ―Ifá therapeutic system [can] assist in solving health problems which defy Western medications‖ (Jegede, O. 2010:20).
Research Questions:
To achieve the set objectives, this study responded to the following research questions:
How is àmódi understood in Yoruba traditional medicine?
What is the procedure followed by babaláwo in their attempts to diagnose and treat àmódi?
At what point does Ifá divination become relevant in the process of diagnosing àmódi?
What are the visible contributions of Ifá divination to the diagnosis and treatment of patients suffering from àmódi?
What are the symptoms of àmódi that can help to enrich the Western categorisation of àmódi?
As we work towards health for all and the pressing agitation for the achievement of the Millennium Developmental Goals, can Ifá therapeutic system be mainstreamed to enhance holistic healthcare?
These questions are vital because ―what a particular society or ethnic group believes about the causation of illness is important in the treatment of illness‖ (Kottack, 1994:62).
1.4 Scope and Limitations of the Study
This study covered two areas: the practice and the processes of Ifá divination among the Yoruba people in Nigeria, although Ifá divination has a wider spread to some other parts of Africa and the world at large.
Studies indicate that the Yoruba and the Bini-Edo of Nigeria, the Fon of Dahomey, who call it Fa, and the Ewe of Togo, who know it as Afa, practise Ifá divination. Beyond Africa, the descendants of Yoruba in Cuba and Brazil also practise Ifá divination (Bascom, 1969:3). The above list does not cover the spread of the practice of Ifá, but the scope of this study is limited to Ifá divination as used in the practice of YTM among the Yoruba people of South Western Nigeria.
This study covered four Yoruba towns, namely: Abeokuta, Akure, Ibadan and Oșogbo. These towns were chosen for two major reasons. First, they are believed to be large enough to represent the practice of Ifá
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divination among the Yoruba people of South Western Nigeria. The process of Ifá divination is one and the same among the Yoruba traditional healthcare providers. This does not rule out minor human factors which come with experience or the environment of the practitioner.
Lagos State was excluded because of the huge influence of civilisation and Western medicine on the practice of YTM, making it difficult to find the required setting for this study. Ekiti State was also excluded because of the distance, which made it difficult for the researcher to have regular access to the patients to be observed.
These towns (Abeokuta, Akure, Ibadan and Oșogbo) are State capitals and they were particularly considered for this study because the study centred on patients with the need for specific and special diagnosis; that is, patients that had exhausted the available Western methods of diagnosis (which are more available in the State capitals) before seeking the help of the babaláwo.
Second, the study focused on one hundred (100) patients out of which twenty-three (23) were chosen for analysis because they were diagnosed to be suffering from àmódi. These patients were chosen across the four towns that were selected for this study.
This study does not cover all the aspects of Yoruba traditional medicine. It is limited to the attempts of babaláwo to diagnose and treat àmódi with the use of Ifá divination. It is also limited to the conditions of àmódi found in twenty-three (23) patients that were observed in the course of this study.
This study simply observed the effectiveness of prescription from Ifá literary corpus; it did not analyse or expound the healing elements present in the prescriptions. This did not reduce the value of this study as it created the basis for further researches in this area.
1.5 Problems of Data Collection
This study focused on Ifá divination as a method of intervening in the diagnosis and treatment of àmódi (somatoform disorder). The problems encountered in the course of the study arose from five areas: (1) the method of patient referral; (2) disposition of patients to be observed; (3) availability of babaláwo who were willing to be interviewed; (4) cross-checking of findings, and (5) schedule for the collection of data.
(1) Method of referral: The ‗informal/oral referral method‘ made it difficult to find documents to show that patients were discharged from the hospitals because they were encouraged to ‗lọ f‟ọwọ ilé tọ ọ ‘ (try the traditional method). This also made it difficult to easily conclude that all available methods of diagnosis were exhausted before going to the babaláwo. This problem arose because the conditions of the patients seemed diagnosable with Western methods, but all the tests results came out negative.
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It was observed that doctors easily and formally admit to discharging patient with known terminal condition, because there are no known treatments for such conditions; but it is not part of the ethics of Western trained healthcare practitioner to prescribe or refer patients to ‗lọ f‟ọwọ ilé tọ ọ ‘ (try the traditional method) even when the conditions prove to be difficult to diagnose.
The researcher overcame this problem by having the babaláwo confirm that attempts had been made to diagnose the condition without any success. This was possible through the process of „ó tán nb‟ókù?‟ a process that uses ìbò, ―the sacred cowry and the sacred bone used in casting lots‖ (Abimbola 1976:12) to further interpret or determine a particular individual situation (Bascom, 1969:51; Oyesanya 1986:4).
(2) Disposition of patients to be observed: Many patients that would have been a part of this study turned down the request to be interviewed because many still perceive going to the babaláwo for healthcare as fetish, and so patronage is largely done clandestinely. This made it difficult for many patients to come out and share their stories or even permit their story to be observed.
The researcher however overcame this and was able to carry out In-depth interviews and observed 23 patients because he participated in the healthcare processes and assured the patients of their confidentiality.
The babaláwo helped to retrieve information from the patients, especially with regard to their previous attempts at diagnosis and treatment using Western methods. This set of questions helped to collect data with regard to the tests that the patients had previously done and how the patients got referred to the babaláwo.
(3) Availability of babaláwo who were willing to be interviewed: Although the researcher chose the babaláwo that were interviewed using a snowball method, he still met with some level of resistance from some babaláwo who felt people had come to exploit their wisdom in the past without acknowledging or rewarding them in some way. These were not supportive and so were not considered as part of the forty babaláwo that were interviewed.
This was, however, controlled by making sure that there were alternate babaláwo to whom the researcher turned. This was possible because there exists some level of link among babaláwo, irrespective of their location.
The researcher encountered another problem based on the fact that not too many babaláwo have the practical experience they claim to have with regard to treating àmódi. Some of the babaláwo that were interviewed, live in the glory of their trainers (Olúwo) and hold onto the theoretical knowledge from the Ifá literary corpus as was told to them during their years of training. This problem was most visible in Akure.
Most of the babaláwo that were interviewed in Akure relied heavily on the experiences of their Olúwo
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(trainers) and stories of success that they had learnt from the Ifá literary corpus. This may be as a result of the fact that many of the babaláwo that were interviewed were young and did not really have personal experiences but this did not reduce the efficacy and trust that is reposed in the Ifá literary corpus.
This problem was taken care of by the fact that babaláwo work together, and so recourse was usually made to older and more experienced babaláwo for their experiences and cases treated. The babaláwo hold that when a babaláwo is in search of knowledge, he could consult any other babaláwo, old or young. Even
―
ọ
rúnmìlà was recorded to have once sought knowledge from one of his children.Àgbà tó mọ ‟yí, kò mọ ‟yí, The elder who knows one thing may not know the other:
A díá fún
ọ
rúnmìlà, The oracular principle divined forọ
rúnmìlàTí yóò sì tún kọ ‟fá l‟ ọ dọ Who would return to learn Ifá from Amósùn, Amósùn rẹ . One of his own followers.
No true babaláwo pretends to know everything. He is always prepared to learn more anywhere and from anybody (Ajayi, 1996:5).
The researcher also observed that some of the babaláwo in Akure practise mainly for money, as some of the babaláwo that were interviewed demanded money before interviews were granted. This is unlike the ethics of regular babaláwo where service is foremost in the reasons for practising. It must be noted that this observation does not represent the general practice in Akure; it only represents the experience of the researcher in the places he went to. And this observation does not in any way reduce the efficacy of Ifá divination. Ajayi (1996) noted that the fact that a babaláwo ‗misrepresents‘ divination does not mean that Ifá divination is not reliable.
Ope ò ș’èrú, Ope (
ọ
rúnmìlà) is not dishonest, Oníkì ni ò gbọ ‟fa, The chanter it is who is not versed in Ifá, Ohun a bá b‟Ifá. Whatever we ask IfáNi‟fá ń sọ. Is what Ifá reveals (Ajayi, 1996:6).
(4) Cross-checking of findings: The researcher found it difficult to crosscheck the prescriptions of the babaláwo using well documented sources because most of the parts of the Ifá literary corpus are still unwritten. To overcome this problem, the researcher made do with recorded interviews and data collected during his period of apprenticeship. The FGDs became helpful in verifying the collected data and to verify and authenticate individual prescriptions.
All the babaláwo that were interviewed individually and in the FGDs hold that Western methods of diagnosis lack the ability to diagnose àmódi - àìsàn tí kò gbọ òògùn, șùgbọ n tí ó șeé wò (a condition that requires more than herbs/medicine to treat).
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There was the problem of validating or authenticating information from divination. This was however overcome with the theory of phenomenology used in this study. Like any ethno-scientific study, the data was taken as reliable cultural practice, even though many scholars ―outside the field hold the view that the art is pseudo-science or has no scientific base and/or proof‖ (Adekola, 1999:185).
(5) Schedule for the collection of data for this study: The researcher found it difficult to work within a structured time frame. This was because the babaláwo were mostly not structured in terms of time. They responded to activities as the occasions presented themselves. This made it difficult for the researcher to plan and work with appointments. Many meetings were schedule and cancelled and some interview opportunities were also delayed.
These delays only prolonged the study, they did not prevent it. The researcher was suspected on a number of occasions to have brought opportunities of making money to the babaláwo. This made the research very expensive.
1.6 Significance of the Study
Given the centrality of diagnosis to healthcare and the unfolding reality, that diagnosis can spread across different healthcare framework, this study becomes significant as it critically examined Ifá divination as an effective complementary method of diagnosis and treatment for àmódi.
Attention is clearly drawn to the fact that disease aetiologies in Yoruba medicine are broader than what is contained in Western healthcare paradigm, making it imperative to expand the methods and processes for diagnosing and treating illnesses especially àmódi.
Ifá divination is a formidable diagnostic and treatment tool for àmódi. Western medicine stands to benefit from it in its attempts to diagnose and treat chronic illnesses. This is so, because ―there is no society without its own art of healing. The types and method of healing in every society is determined by the ecological and social-cultural environments as well as historical antecedents of the people‖ (Jegede, A.
2010:1).
1.7 Description of Concepts
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This section describes four concepts and the operational definitions they have within the context of this study. These operational definitions were derived from literature and applied to the study as explained.
(1) Diagnosis in Ifá divination; (2) Disease and disease aetiology in Yoruba traditional medicine; (3) Ifá divination among the Yoruba people; and (4) Àmódi (somatoform disorder).
1.7.1 Diagnosis in Ifá Divination
Diagnosis in Ifá divination is the search for the causes of things with Ifá divination as the guiding tool. It examines the present condition of the patient against what is contained in Ifá literary corpus. This process begins with an observation of the patient and a narration from the Ifá literary corpus, after which the patient locates his/her story within the narrative. This process helps to unveil or diagnose the patient‘s disease aetiology, thereby proffering possible solution in the form of the prescribed treatment.
Prescribed treatment may be one or a combination of the following: (1) ẹbọ (sacrifice), (2) òògùn/àkóse-Ifá (medicine), (3) ọgbọ n/ojú- inú (inspiration).
Ikin-Ifá (sixteen Ifá palm-kernels) and ọ pẹ lẹ (Ifá divination chain) are the two major diagnostic tools used by the babaláwo. A process called, Ó tán nb‟ókù? (Is this all or there is more?) is employed to confirm the diagnosis. This process flows through a set of questions to confirm whether all that needs to be known or done has been accomplished.
Ó tán nb‟ókù? ends both the diagnosis and treatment processes. It is what Western medicine calls post- treatment test. It helps to confirm the condition of the patient through the use of ìbò, ―the sacred cowry and the sacred bone used in casting lots‖ (Abimbola 1976:12). As Bascom (1969) and Oyesanya (1986) noted, Ìbò is used to determine and further interpret particular individual situations.
1.7.2 Disease and Disease Aetiology in Yoruba Traditional Medicine
Yoruba traditional medicine acknowledges two possible divisions of disease: the natural (explicable) and supernatural (inexplicable) disease. It is believed that natural diseases have explicable disease aetiologies and treatment, while supernatural diseases have culturally known but not explicable disease aetiologies.
For scholars (Oke, 1982, Osunwole, 1989, Jegede, A. 1994, 1996), this distinction is linked to the fact that what constitutes an ailment is a subject of contention between Western medicine and traditional medicine.
―Too much emphasis of modern medicine on germ theory of disease has made it loose sight of other factors as recognized by traditional medicine‖ (Jegede, A. 2010:56). This is because the culturally known causes do not fit into the logic and sequence of Western science and practice.
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Disease is perceived from four main aetiologies: the natural, supernatural, mystical and Oke (1982) and Jegede, A. (1996) added hereditary to the list of disease aetiologies. For the Yoruba, all the different forms of disease aetiologies are known and contained in the Ifá literary corpus. These disease aetiologies are recognised as part of the broader disease aetiology in Yoruba traditional medicine within the context of this study.
1.7.3 Ifá Divination Among the Yoruba
Ifá divination consists the selection of a single group of verses from the Ifá literary corpus. This process is regarded as ―a geomantic type of divination, a system that has 256 Odù (chapters) which a babaláwo is to learn by heart‖ (Simpson, 1994:73). These 256 Odù are divided into two significant parts: Ojú Odù mérèrìndínlógún (16 major Odù) and àmúlù Odù (240 minor Odù). Each of the odù is made up of the ẹsẹ (verses).
Each of these 256 Odù has its own divination signature. It is the ẹsẹ attached to each of these signatures that is chanted during divination. The ẹsẹ explains the diagnosis, prescription and method of administering the medicine that has been prescribed as the treatment for the condition that is being diagnosed. Whatever emerges from the signature is what the babaláwo prescribes to his client. It is believed that ―ẹsẹ-Ifá pervades the whole range of Yoruba thought and action throughout history‖ (Abimbola, 1976:32).
According to Abimbola (1976), the process of divination is interpreted with the throwing of ọ p l on the ground, the combination of nut segments which fall ‗up‘ or ‗down‘ tells the Odù to be interpreted. The babaláwo then recites from the memorised passages what relates to the Odù that came up after the combination of the nut.
ọ
p l is used for everyday divination, while Ikin is reserved for very important and difficult occasions. For the purpose of this study, Ifá divination shall be understood as the process of casting of either p l or Ikin, the interpretation of the signature that emanates, the recitation or chanting of the relevant ẹsẹ-Ifá to the patient, the patient‘s ability to point out the relevant part of the chanted or recited ẹsẹ-Ifá, the prescription and the administration of the prescription.1.7.4 Àmódi (Somatoform Disorder)
According to the American Academy of Family Physicians (2010), somatoform disorder, known as Briquet's syndrome (named after Paul Briquet), or Brissaud–Marie syndrome (named after Édouard Brissaud and Pierre Marie) is a mental disorder characterised by physical symptoms that mimic physical
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disease or injury for which there is no identifiable physical cause. It is also known as Medically Unexplained Physical Symptoms (MUPS) or Medically Unexplained Symptoms (MUS). The symptoms that result from somatoform disorder are claimed to result from mental factors. Medical test results are either normal or do not explain the symptoms found in people who have somatoform disorder.
Àmódi (somatoform disorder) has been observed to constitute a serious medical problem known to challenge the competence of physicians (Lipowski, 1988). This has made Quill (1985) refer to it as one of
‗medicine‘s blind spots‘; and similarly, Lipowski (1987) called it ‗medicine‘s unresolved problem‘.
Different from the above description, findings have shown that somatoform disorder is expressed differently in different cultures because of (1) the difference in styles of expressing distress, (2) the ethno- medical belief systems in which these styles are rooted, and (3) each group's relative familiarity with the healthcare system and pathways to care (Kirmayer & Young, 1998:420).
These bring about the differences in somatisation across ethno-cultural groups even where there is relatively equitable access to healthcare services. Findings show that different things may be responsible for somatoform disorder, making it difficult to classify the nature and causes of somatoform disorder.
In line with this, the Yoruba understand and call this type of condition àmódi, a condition without a name or a disease that is difficult to diagnose or understand. For the purpose of this study, àmódi (somatoform disorder) is understood as that condition which Western method of diagnosis found impossible to diagnose and so could not treat.
For the purpose of this study, àmódi will represent any condition that is not diagnosable or any condition with unexplainable symptoms. This will include ―patterns of behavior or feeling or thinking which interfere significantly with the individual‘s ability to work, to fulfil adequately his/her expected role, to get along with other people, or to enjoy life‖ (Asuni, Schoenberg & Swift, 1994:42).
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CHAPTER TWO LITERATURE REVIEW
2.0 Introduction
This literature review focused on four major areas: (1) African Traditional Medicine (ATM), (2) Yoruba Traditional Medicine (YTM), (3) Ifá divination as a method of diagnosis, and (4) Somatoform disorder
2.1 Diagnosis and Treatment of Diseases in Western Medical Practice
Western medical practice as practised today gives no insight to the historical fact of a Pre-Hippocrates‘
medicine which incorporated the use of plants, animal parts and minerals. This departure from the past has affected the nature and practice of Western medicine. There is a huge emphasis on empirical biomedical research, which builds on evidence-based medicine. This has made Western medicine to focus on diagnosis and treatment of diseases and conditions that are treatable and linked to physical causes.
In Western healthcare practice, ―diagnosis refers either to an active process or to the conclusion reached by that process… the active sense includes the process and art of using scientific methods to elucidate the whole compass of problems that influence a sick person‖ (W.B.B, 1973:684). Science determines what is employed in the process of diagnosis and explains what is found in preparation for treatment.
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Diagnosis is measured ―in the light of a knowledge of the principle of anatomy, physiology, and pathology, concepts of the causes of the trouble, the pathological lesions, and the disordered processes that make up the patient‘s disease are formed‖ (W.B.B, 1973:684).
Diagnosis leads up to treatment, based on the findings and understanding of diagnosis and prognosis, whether the treatment be taking a pill, receiving an injection, undergoing a surgical procedure or embarking on a therapy. Every process is explained and adopted using scientific methods. It is different from ATM where diagnosis and treatment include “theories, beliefs, and experiences indigenous to different cultures, whether explicable or not” (WHO, 1978).
2.2 African Traditional Medicine (ATM)
ATM is not a new field of inquiry. Different scholars have attempted to define it, even though it is difficult to agree on a generally embraced definition. This difficulty in defining ATM and the fact that it was gaining popularity made WHO attempt a definition that can harmonise the existing definitions and views.
World Health Organization (WHO) held that:
Traditional medicine is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness (WHO, 1978).
Sharing the same understanding, Mume (1984) came up with his definition for ATM. He called it
―tradomedicalism‖, which means:
methodology and mechanics of treatment of human diseases as applied by our forefathers and which has been practiced by succeeding generations to this day. It is a system of treating diseases by the employment of agencies and forces of nature… this follows definite natural, biological, chemical, mental and spiritual laws for the restoration and correction of bodily disorder (1984:3).
Ampofo and Johnson-Romauld (1987), not too differently, defined ATM as the ―totality of all knowledge and practices, whether explicable or not, used in diagnosing, preventing or eliminating a physical, mental or social disequilibrium and which rely exclusively on past experience and observation handed down from generation to generation, verbally or in writing‖ (Ampofo and Johnson-Romauld, 1987:38).
Ogungbile (2009) also define ATM as ―the health practice involving the application of indigenous resources, spiritual and material, in providing mental, psychological, social, and physical well-being and wholeness to a human being and his or her environment‖ (p. 413).
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These definitions did not end the discussions on the nature and spectrum of ATM. There were other attempts to broaden and specify the areas of interest of ATM. Sofowora (2008), further 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‖ (p.
2).
These definitions agree on the fact that ―traditional medicine is an ancient medical practice that existed in human societies before the application of modern science to health, [they also realize that] it has evolved to reflect different philosophical backgrounds and cultural origins‖ (WHO, 2011). These views complement the works of scholars like Asuni (1962, 1979), Leighton, et. al. (1963), Lambo (1955, 1956), Oyebola (1982) and Pierce (1980), who have carried out researches and observations on some African traditional methods of healthcare.
Traditional medicine of ―any given human group in Africa is a complex phenomenon straddling both the seen and the unseen worlds‖ (Ogundele, 2007:128). The attempts to capture the different realities in the practice of African medicine arose different interpretations. Some scholars saw ATM as a fetish way of curing diseases. To some others, it is believed to be a method of healthcare for the poor and the illiterate given the fact that it is cheaper and more accessible to the average person especially in the rural areas.
Yoder (1982) noted that most studies in ATM before the 1970s dismissed belief systems, religions and rituals as formidable aspects of healthcare. Scholar such as Evans-Pritchard (1973) and Thairu (1975) referred to African traditional healers as witch hunters who practiced ―black magic‖ and took care of their patients with occultic powers. Notions such as these gave ATM the negative outlook it had for decades before the current acceptance it enjoys.
The development in Western medicine initially did not help traditional medicine because it gave the impression that indigenous, ancient or traditional medicine had no validity, and was nearly extinct. But this is not the case, traditional medicine ―clearly existed in the East and the Third World, and was in hiding in the Western culture, where it took a defensive cultic posture in the face of modern medicine‘s self- confidence‖ (Fulder, 2005:3).
Today, more scholars realise that traditional medicine is as old as the time of the emergence of the earliest human and that it has helped in the preservation and maintenance of good health. This realisation has brought about ―a radical renewal of interest in, and use of, traditional or alternative medicine. So much so, that we are ―re-entering a period in which scientific medicine and its services share and compete for customers with alternative medicine, within a pluralistic national medicine‖ (Pietroni, 1991:13).
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Having accepted ATM as a reality, it is important to also acknowledge the distinguishing nature of ATM.
Studies in traditional medicine show that its practice cannot be separated from the African way of life.
Diseases are perceived and treated within the context of the culture. This is because ―medicine does not develop in isolation. Health care practices are often driven by cultural context, economics, politics and power‖ (Richardson, 2005:26).
The WHO‘s definition of health as ―a state of complete physical, mental and social well being‖ reflects the Yoruba understanding of ‗àìsàn‟ (not being well or that which distorts health). Jegede, A. (2010) noted that for the Yoruba, ―to be well does not only mean biological well-being but the holistic condition of the individual and the society‖ (p. 223). That is, to be healthy is more than just being free from diseases or infirmity. One has to be in harmony with the ‗self‘, ‗society‘ and Olódùmarè (Almighty God).
This is why, as observed by McIvor (1989), traditional healers in Zimbabwe are consulted on a large variety of health problems and Twumasi (1984) also noted that the same happens in Zambia. Findings show that, ―over 75 per cent of the rural population in Africa seeks healthcare among traditional healers‖
(Ampofo and Johnson-Romauld, 1987:38).
The extent of patronage and observable efficacy of ATM has led to the appreciation of ―the four criteria of accessibility, availability, acceptability and dependability‖ (Nchinda, 1976:134) of ATM. These are reasons why the millennium goal of ‗health-for-all‘ cannot be achieved in Africa without ATM. Indeed, the British Medical Association (1993) acknowledged that alternative medical systems are full systems that have come to stay, doctors are encouraged to learn about alternative medicine even at undergraduate level, and if a doctor wishes to study them, he or she must undertake a full course of instruction.
2.3. 1 Yoruba Traditional Medicine (YTM)
Yoruba traditional medicine has developed in and with the culture of the Yoruba people and, as it developed, different scholars found different aspects of it fascinating. Scholars have examined the origins, the history and the nature of Yoruba Traditional Medicine (YTM). These various studies have expressed interests in the two different divisions that exist in YTM. That is, the natural (explainable) and the supernatural (inexplicable), as captured in the definition of WHO (WHO, 1978).
Esho (2005) noted that:
traditional medicine falls broadly into two divisions, namely the physical and the metaphysical. The physical division uses vegetable, animal and mineral substance. The vegetable substances can be parts of plants such as roots, stem, leaves, flowers or bark or combinations of any of these. The animals used include snails, chameleon, snakes, tortoise, rats, lizards and many others. Among the mineral substances used are crude antimony, sulphur and chalk. The metaphysical division is concerned with the invisible
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world. Prayers, invocations or incantations are offered to some mysterious but apparently powerful forces (p. 32).
These two aspects or divisions of Yoruba traditional medicine have been traced to the same origin.
Odugbemi (2008) and Sofowora (2008) noted that in trying to account for the origin of Yoruba traditional medicine, different legends and different accounts of the legends have been alluded to. Some people believe that the origin of Yoruba traditional medicine revolves round some deities such as
ọ
rúnmìlà,ọ
sanyìn, Olúbíkin,ọ
sanyìnbíkin, Ajigbẹ àkùrọ -Odunko, etc. These are believed to be the first set of people who practised Yoruba traditional medicine (Odugbemi, 2008:13). But a more popular legend has it that―the first man to practice the art of healing in the Yoruba speaking part of Nigeria was
ọ
rúnmìlà, who was endowed with this knowledge by God.ọ
rúnmìlà had a younger brother calledọ
sanyìn who gained knowledge of medicinal herbs through assisting his elder brother to compound drugs‖ (Sofowora, 2008:13).ọ
rúnmìlà is believed to have used words and herbs to heal the sick and through divination he is said to have taught about the existence of Olódùmarè and revealed the causes of diseases, prescriptions of therapy and sometimes instructed on what plants to use and the methods of application (Odugbemi, 2008:13). This is based on the belief that the Ifá literary corpus contains all that needs to be known in every situation.The natural or explicable aspect of the Yoruba traditional medicine is traced to
ọ
sanyìn who is known to have treated ailments with only herbs. To complement the account of Sofowora (2008), scholars noted thatọ
sanyìn, is believed to be ―the only man on earth who knows about medicinal plants and their uses other than those revealed by divination throughọ
rúnmìlà‖ (Odugbemi, 2008:13). This makes him the patron of herbalists. On the other hand, the supernatural aspect is majorly traced toọ
rúnmìlà, even though some other divinities are believed to have been assigned powers by Olódùmarè to carry out healing (Odugbemi, 2008:13).Although the attempts to trace the beginnings of Yoruba traditional medicine are based on legends, there have not been enough tangible reasons to suspect or dismiss these attempts. These legends only show that the art of healing among the Yoruba people has existed independent of religion unlike what many authors claimed.
The separation of Yoruba traditional medicine from religion is not a general position. Some scholars, especially anthropologists, have found no difference between Yoruba traditional medicine and the Yoruba
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traditional religion, and this has brought about a misunderstanding, as Osunwole (1989) noted, that most of the 19th and 20th century writers on Yoruba traditional medicine conceived of it as juju or magic. To strengthen Osunwole‘s view, Jegede, O. (2010) argued that ―a majority of anthropologists and sociologists who visit Africa take medicine and religion to mean the same thing; even African scholars continue to present African medicine as a form of magic‖ (p. 19).
Evan-Pritchard (1973) and Buckley (1997) also hold that if one does not understand ATM, it will be called magic. This understanding stands in the way of holistic approach to diagnosis and the use of diagnostic methods like Ifá divination.
This may be linked to Lucas‘ (1996) claims that the Yoruba once lived in ancient Egypt before migrating to the Atlantic coast, and ―with Egypt at its root, it is therefore inevitable that African herbal medicine became associated with magic. Amulets and charms were more common than pills as preventions or curatives of diseases‖ (Lucas, 1996: 291).
This lack of separation has led scholars like Simpson (1994) to undertake studies of Yoruba religion and medicine with a particular focus on the people and practice in Ibadan. Simpson (1994) found that the healthcare practice among the Yoruba gives room for the belief in both natural causes of diseases as well as supernatural causes like witches. He acknowledged that the supernatural causes warrant the use of Ifá divination as a tool for diagnosis and prescription. Through this observation, Simpson (1994) clearly made a distinction between what is natural (explicable) and what is supernatural (inexplicable).
This is not a general view as many other scholars have not made this distinction between Yoruba traditional medicine and religion. The argument for the continued separation between religion and medicine, according to Hadley (2003), is based on the position that religion is irrelevant to health or that it has negative effect on health. For Hadley (2003), health is purely scientific and to mingle religion with health steps down the progress in the advancement of medicine.
But Buckley (1997), believes that scholars like Hadley have difficulty in understanding traditional medicine because ―there are undoubtedly some healing techniques used in African culture [including the Yoruba] which seem to contradict both scientific knowledge and common sense‖ (p. 17). Jegede, O. (2006) went further to stress the link between the YTM and religion. For him, ―in traditional religion, religion and medicine are connected and are ever crossing each other. Thus, African therapeutics is medico-religious. It includes the use of divination, rituals, and sacrifices, as well as incantations, from aetiology diagnosis to the management and treatment of diseases‖ (p. 64).
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Abiodun (2005) agreed with Jegede, O. (2006) by arguing that the traditional perception of health with its metaphysical presuppositions enhances the functionality of Yoruba traditional medicine and it makes it more appropriate to the needs of the people than Western medicine that is inherently bacteriologic.
Views like these cannot be separated from the interests shown by scholars like Dopamu (2000) who took interest and discussed the use of
ọ
fọ ìș gun (incantations for victory). He argued in favour of Yoruba traditional medicine and magic and held that they are both scientific. Even though his arguments did not clearly justify his claim, he held that among the Yoruba, magic, medicine, religion and science have survived till today. In line with this, Jegede, O. (2010) explored the knowledge and use of incantations and herbs in Ifá divination as a category of Yoruba traditional medical practice.This lack of total distinction between Yoruba traditional medicine and religion does not enjoy a wide acceptance as scholars are making effort to make clear distinction between medicine and magic. In an attempt to help with the distinction of categories, Jegede, O. (2010) noted that the Yoruba word ajẹ bíidán, which translates as ―efficacious as magic‖ may be responsible for confusing medicine, magic and religion.
Evan-Pritchard (1973) and Buckley (1997) hold that if one does not understand African traditional medicine, it will be called magic, because it works like magic. Building on this distinction, Osunwole (1989) noted that, ―recent anthropological works reveal that Yoruba traditional medicine is not magic‖ (p.
14).
Given the contents of legends and the experiences of people as they use Yoruba traditional medicine, one has no doubt as to its existence. What some scholars are now interested in is to examine the claims that Yoruba traditional medicine is potent and can diagnose and treat common diseases.
Yoruba traditional medicine has not always enjoyed acceptance and has not always been understood by scholars as it is today. Most of the acceptance ATM enjoys today stem from the explicable aspect. Scholars like Asuni (1962, 1979), Leighton, et. al. (1963), Orubuloye (1979), Oyebola (1982) and Pierce (1980) have embarked on researches that focused on herbs and the composition of these herbs. This aspect of the divide in Yoruba traditional medicine has enjoyed the attention of botanists and pharmacologists and has helped to explain the choices made of herbs and the reason for the combination of certain herbs, why they are plucked at certain times of the day and not at other times.
This has led scholars to be interested in other areas of Yoruba traditional medicine. Scholars such as Ademuwagun (1975) became more interested in examining the contribution of Yoruba traditional medicine to the development of healthcare in Nigeria. He examined the relevance of ritual and healing in modern healthcare delivery, given the growth and the awareness of the efficacy of Yoruba traditional medicine.
Ademuwagun (1975) noted that, ―in Nigeria today, health care delivery is obtained from both the Western-
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trained doctors and traditional healers. The two systems co-exist and are freely patronized by the health consumers‖ (p. 185).
The development of the natural (explicable) aspect of Yoruba traditional medicine is not to the exclusion of the supernatural (inexplicable) aspect. This is largely due to the influence of and the contributions of anthropologists and ethno scientists who have taken interest in the Yoruba culture and religion. Buckley (1997) acknowledged that traditional medicine ―forms part of the rich cultural tradition of a Yoruba town‖
(p. 1). With this acknowledgement, he went further to tie Yoruba traditional medicine and religion together by noting that even though Yoruba traditional medicine ―in many respects should be regarded as distinct from the mainstream of traditional Yoruba religion, like many other parts of Yoruba culture distinct though, it is, it is inextricably intertwined with it‖ (p. 1).
This link he noted does not remove the existence of natural disease causation because, in Yoruba healthcare paradigm, there is the awareness that diseases can be caused by worms (aràn) and germs (kòkòrò), over- indulgence in food, drink and sex and any other thing that can harm the body.
Buckley (1997), while carrying out a fieldwork on the practice of traditional medicine among the Yoruba, rapidly discovered that ―almost all Yoruba men knew at least a little about traditional medicine (òògùn)‖ (p.
2), stressing the focus of traditional medicine to be care for good health. Beyond the general knowledge, Buckley (1997) observed that there are men properly called oníșègùn, who are the professional herbalists.
These he referred to as more knowledgeable in the practice of Yoruba traditional medicine. They represent the aspect of Yoruba traditional medicine that is natural (explicable). They understand the physiological make-up of humans and the herbs that can help in preventing and curing diseases.
2.3.2 The Concept of Incurability, „àrùn tí ò șeé wò’
In YTM, distinctions are made between àrùn tí ò șe é wò (incurable disease) and àrùn tí kò gbọ òògùn (a disease that cannot be cured with medicine alone). Jegede, O. (2009) properly articulated this distinction between, àrùn tí ò șe é wò and àrùn tí kò gbọ òògùn. He noted that for the Yoruba people, this distinction is possible because medicine is not the only means by which human illness or disease can be cured. Jegede, O. (2009) quoted Baba Awo Ojekunle, herbalist and diviner, as saying that ―the concept of incurability of a particular disease does not exist in African traditional religion and medicine‖ (p. 23). This is because disease or illness is viewed and responded to holistically beyond the responses given to physical or naturally caused diseases.
One of the most threatening and consuming words in Western medical model is incurability, that is, àrùn tí ò șe é wò. But this is not the case in YTM. For the Yoruba, every disease in existence today had existed and
