e-mail: tyeboah@mail.unam.na
In many rural communities of developing countries, the use of remedies based on traditional medicine form the basic core of health care. This paper shares the view that traditional medicine complements modern medicine and is not 'alternative medicine'. Traditional medicine has a systematic methodology of its own and a body of knowledge preserved through many centuries and passed on orally from generation to generation. Charlatans easily exploit this indigenous traditional medical knowledge and cheat ignorant people.
a. In the mainstream of national health care systems, a forum for traditional health practitioners be created to institute public policies including legislation for indigenous medical systems.
b. Health centres in rural communities are made 'research schools' for scientific study of traditional medicine so that an effective interaction with the community and traditional healers can be forged.
c.Every program to bridge the gap between traditional and modern medicine must include information dissemination component. The information wings of such programs are not to be libraries but manned by personnel who can relate to the people and would use the public media (village meetings, radio, television, cinema, etc.) to keep people informed about health care issues.
The paper concludes that purposeful provision of indigenous medical information would greatly improve the performance of traditional healers as well as educate the rural poor on personal hygiene practices and general health care issues.
Introduction
One of the popular contemporary paradoxes is that, countries with the richest exploitable natural resources contain the majority of the poorest people on earth. These countries are in reality undergoing underdevelopment compared to the western industrialized countries. However, they are referred to as 'developing countries or the third world' probably to encourage the people to continue struggling to better themselves and not to feel a sense of futility. The reasons for the plight of developing countries have been linked to their colonial past, geographical location (almost all of them lie within the equatorial belt), and other socio-economic factors. It is believed that these influences can be brought under control and that third world peoples can create and enjoy a high standard of living.
For example, rural communities of developing countries face the more serious problems of illiteracy where the greater majority of the population are unable to effectively communicate with themselves as well as outside counterparts. The accessibility of necessary information and the ability to relate to the literate world are very important conditions for a fruitful fullfilment of the developmental aspirations of the community. Rosenberg and others observed in a study of rural information provision in developing countries, that the high failure rate of rural projects could lie within the process of information transfer in the rural sector. Development programmes only reach their full potential if agents transfer their knowledge and techniques and if peoples are motivated to make use of them. People become the principal actors in any change therefore their participation and initiative must be harnessed1 .
In recent years there have been meetings and conferences which have discussed projects to integrate traditional and modern medical practices in developing countries2,3,4. Emerging from the literature, the concept of traditional medicine is classified as non-orthodox therapeutic systems, sometimes making use of mystical and magical rituals, which have no satisfactory scientific explanation for their effectiveness. It Includes African traditional medicine , Arabic medicine, Ayurvedic medicine, Herbal medicine, and Oriental traditional medicine. Integrating modern and traditional health care practices is a search for practice models that can promote the type of development that people can understand, afford, relate to, and control. Pearce5 suggests that patients must have an input into the development of new medical material (or systems) because in their search for answers to their problems they acquire and hold useful knowledge. It is in this context that an information organization, storage, retrieval and dissemination project is appropriate within the exercise to integrate traditional and modern medical practices.
This development is important for modern medical practitioners, who have to understand traditional medicine, with regard to its mission, and processes. The domain of traditional health care practices, and expertise of its practitioners, must be clarified so that the legitimacy of indigenous knowledge, its philosophy, and value bases can be established within the national health system.. It is necessary to resolve these issues to ensure the proper and safe use of traditional remedies and facilitate the utilization of local resources. The move is very welcome to the rural and urban poor who cannot afford the modern expensive therapeutic system. There is also the belief that research into indigenous practices can provide solutions to therapeutic problems which have not been solved by modern medicine. Again, herbs have become an economic resource and at the moment The Ghanaian Chronicle reports a multi-billion dollar bonanza for herbalists and medicinal plant growers at The Centre for Research into Plant Medicine, Akuapem-Mampong6.
Indigenization of medicine and promotion of ethnomedicine in Ghana.
As a result of colonialism, educational enlightenment, and Christianity, traditional medicine has been wrongly labeled unscientific, therefore, before
However, traditional medicine was, and remains very popular. As the culture of the people, it offers easily understandable techniques, and makes drugs and interventions readily available. Furthermore, as observed by Kufuor, about 70% of the population still rely on traditional medicine8, largely because they cannot afford the costs of modern scientific medicine. It has also been observed that biomedical science has not been adequate in providing solutions to certain local therapeutic problems, and in many instances traditional medicine has been able to provide more effective treatments.
With independence in 1957 came various activities, research programmes, and health projects which launched and intensified the popularity of traditional medicine. There was the nationalists' campaign to promote African cultural identity which called for indigenization of medicine. Indigenization in the exercise means that the theories , values, and philosophies that underlie practice must lead to the development of practices based on the needs of the people, their culture and economic landscape9. In the years following independence, this ideology shaped the policy of extending health and welfare services to rural areas and encouraged research into indigenous medicine. The vision was to develop traditional medicine to the same level as western medical practice, and as an integral part of the Ministry of Health, as well as within the cultural beliefs of the people. Commissions were set up to advice government10,11 and various projects and activities sprang up bringing indigenous health knowledge into the limelight of scientific attention. Notably, the
All these were attempts to modernize indigenous medicine and in the process a knowledge base has been created from which biomedical and ethnomedical sciences can extract information for practice research, and development. This knowledge also needs to be organized, repackaged and disseminated to health care practitioners and the general public the majority of whom are illiterate and semi-literate rural dwellers. Even though contemporary studies reveal traditional medicine as highly organized systems13,14 , and healers have won the respect of academics, during the indigenization process, the integration of ethnomedicine with biomedicine has not been smooth. There exists a pluralistic health care system that allows modern and traditional medical practices to operate and provide health information services side by side.
The modern health care system is the western based method of practice run by the Ministry of Health and the religious churches. Under this system are the hospitals, clinics, health centres, drug stores and dispensaries. The Ministry of Health operates other units including Public and Community Health Nurses Departments, Medical Field Departments responsible for the control of communicable diseases, and the Sanitary Health Inspection unit. In some of the drug stores and dispensaries, prescriptions are not required and illicit injections may be obtained.
Traditional healers form the other health care system and consist of two main categories, namely, the priest / priestess and the herbalist. The priest in most cases owes divine allegiance to a local deity and rarely traveled outside his shrine and definitely never advertises his products nor knowledge for commercial purposes, because they are associated with divine powers which do not require human recognition for their efficacy. The priest does not possess the knowledge per se but obtains it from the god and therefore has no authority to disclose the nature of ailment let alone the names of herbs or sources of intervention to a patient. The herbalist is also recognized as possessing supernatural powers but does not represent a deity. There are full time and part-time herbalists and, in all cases the practitioner has acquired useful knowledge about diseases and drugs and would willingly pass on this knowledge to friends and the sick. The interaction between the herbalist and the rural people is on the highest level compared to priests/priestesses or modern medical practitioners. Spiritualist churches also operate as healing shrines and belong to the health system though their mandate to operate does not derive from their role as healers. These are facts and common knowledge in
The biomedical and traditional systems have supplemented each other but never seem to identify common grounds for linkage during and after the colonial period. Especially with regard to communication, there continues to be misunderstanding between health workers and illiterate rural communities. Among prevailing issues, the problem of transferring the knowledge generated at the centres of traditional medicine to the illiterate community has been persistent. Dissemination of indigenized health knowledge has not been addressed adequately and consequently, health information needs of the rural folk remain unsatisfied. The envisaged desirable and possible cooperation of ethnomedicine and biomedicine has not included any programmes to inform illiterates about health matters. Health care information continues to be provided through libraries and resource centres and illiterate communities are left on their own to satsify their information needs.
Communication with Rural Communities in Health care.
It has been observed that many rural dwellers are ignorant of their health information needs or at least cannot articulate them17. If health workers lack the communication skills to identify health information needs of the illiterate folk, they cannot provide needed services at the right time. Sometimes indigenous terminology cannot be communicated in English, a situation which makes it difficult for the health personnel who does not speak the local language to understand the needs of the patient. In other situations, the instructions given by a doctor might be ignored because they conflict with the cultural beliefs and practices of a patient. Twumasi18 suggests that opposing cultural beliefs can and, tend to colour therapeutic relationships. If patients are unable to understand or accept medical explanations and instructions that are inconsistent with their belief system, they would not abide by medical instructions. In such situations, patients might lose confidence in medical practitioners and medical practitioners might refuse to attend to patients.
It is a fact that in the measure in which the effort to integrate traditional and modern systems has succeeded a communication gap has been created between health workers and illiterate rural dwellers. This gap has been filled by semi literate drug peddlers who are accepted by rural people as competent, knowledgeable herbal pharmacists and healers. Admittedly, peddlers perform much needed services for the rural people and the urban poor. Unfortunately, there are charlatans among them who use their position to cheat ignorant people. They are able to get away with their crimes due to two main factors.
Marketing of drugs and Health Information Transfer.
First of all, the peddler possesses the qualities of the common traditional healer, ie. "Using methods based on the social, cultural and religious background as well as the prevailing knowledge, attitudes and beliefs regarding physical, mental and social well-being and the causation of disease and disability in the community19". For example, a typical observation among rural dwellers and the urban poor is that everybody practice medicine. People try home remedies first before resorting to professional practitioners. It may require money and traveling away from home to a distant place before a herbalist or fetish priestess can be reached for consultation. This is where the peddler steps in to provide information and interventions to fill the gap between what the patient knows and what he requires to know. The peddlers in the rural communities move from house to house to sell their drugs and also transfer new knowledge to the people.
Another illustration which demonstrates cultural identification of the peddler with the people is the marketing gimmicks designed to educate the ignorant about health issues but has the hidden motive of advertising the efficacy of traditional preparations. These sales operations take place at market places, transport terminals, on trains, on buses and indeed any conceivable meeting place where people gather in the villages and towns. Typically, the well prepared speech in the local language would begin with a prayer which psychologically is worded to prepare the minds of the people that the message they are about to receive is an inspiration from a divine power. A thorough description of an ailment from aetiology through interventions to preventive measures will then follow. The conclusion would be a medication which will be offered for sale at a reduced cost so that the poor can afford to buy. There is always a reminder that anybody who declines to take advantage of the generous offer stands to lose, and might regret miserably in future.
The captivating power of these rhetorics can arrest the attention of anybody including medical personnel. This presenter fell a victim by purchasing a medication supposed to cure fevers and general bodily pains on a passenger bus. The feeling of renewed energy one is supposed to obtain from that drug turned out to be a severe stomach upset with diarrhea which ended up in the hospital. Perhaps this account is an only one-off unfortunate incident, however as will be pointed out later in this presentation it is a relevant episode. In general, peddlers are specialized in their fields of treatment and one may not sell drugs for more than two diseases. However, occasionally, a cure all miracle preparation may be presented.
The second reason for the high image of peddlers derives from the indigenization campaign of the 1960's. In fact, the promotion of African culture at the time was a calculated political propaganda to indoctrinate the youth and the masses with the socialist ideology pursued by the government. The popularity of the government made the indoctrination so effective that rural dwellers were very well informed of all the projects which needed 'reforms'. Consequently, the greater majority of rural people knew about well established traditional medical projects and clinics. It therefore needed very little effort to convince the people that their products are genuine if peddlers can link themselves with one of the established centres. To emphasize this claim they put their preparations in brightly labelled containers bearing logos of recognized herbal clinics or associations. They sometimes go further by providing the addresses of established healers for reference. Peddling in this fashion continues to be big business of aggressive marketing of herbs and other medical preparations, and takes place all over the country.
Health care Information Dissemination.
Apart from traditional preparations, peddlers also impart information about other health care issues as personal hygiene, food and nutrition, family planning, child and maternal health, environmental health, diseases and preventive medicine. Traditional clinics also impart health care knowledge to the public, but only such recorded and published information which results from scientific analysis of herbs and techniques of the healing systems. The emotional, psychological and spiritual knowledge component of indigenous medicine is not dealt with in science and therefore not discussed by biomedical science practitioners even if they believe in them. As observed by Mensah Dapaah, in his research and organization of traditional healers in
Unfortunately, the non-scientific knowledge is believed and even feared by most people and therefore charlatans use it to boost their image and reinforce the authority of the health care information they disseminate. By means of specialized techniques in oratory they claim that modern science cannot provide treatment for certain diseases which they are able to cure. Proving their claim with anecdotal evidence, research results from their centres, and personal experience, they educate their audience in all aspects of health care and provide interventions. The problem with anecdotal evidence is that it is often selective, retaining only positive results21. A case in point is the claim that an African potato variety can control the HIV/AIDS disease22, . This information was released in
Surely, modernization of traditional medical systems have a role to play in the commercialization of traditional medicine and the abuses of traditional knowledge by peddlers. The attempts to integrate traditional medicine into modern mainstream medicine, have called for regulation of the practice, to register practitioners, to licence premises for practice and to monitor the preparation and selling of drugs. It was speculated that regulating the system would control health-care fraud, in that practitioners and herbal pharmacists who have been in existence for a long time can be held accountable in law and malpractice or fraud. However, it was only in 1999 that a Council with legal backing was established to regulate the practice of traditional medicine23 . The reality is that because of the faith and fear people impose in the spiritual world indigenous medicine has a high status locally and continues to exercise a deep influence on experience and conduct. Consequently, matters concerning indigenous healers are discussed with caution and discretion. Traditional practitioners are rarely confronted or reported for misconduct and continue to enjoy high recognition in the community even though there are numerous cases of fraud, misconduct and criminal activities against some of them. People have actually been poisoned by taking herbal prescriptions from peddlers, many teenage girls have lost their lives or become childless in later years for taking prescriptions or employing techniques sold by peddlers to induce abortions. In the Southern African Region the claim by unscrupulous healers that having sex with a virgin can cure the AIDS disease has increased the number of rape cases and incidence of the HIV/AIDS infection24. The time is ripe for the ignorant and the superstitious to be protected from false and dangerous indigenous health knowledge so that shameful and criminal acts like the above can be avoided. There is no doubt at all that peddlers can sometimes be very dangerous to the total well being of the communities in which they operate.
Modern biomedicine concedes that every medical procedure or agent carries a risk, and not all indigenous treatments are risk free but on the contrary, the majority can be dangerous. Folk remedies rarely have to pass rigorous clinical trial tests demanded of mainstream medical therapies, and have no records of successes nor failures whilst dangers are overlooked25 . The concern of any health system should be the provision of the best possible medical care for the cultural environment in question. Illiterate communities in developing countries need accurate health care information that would develop their scientific consciousness on a continuous basis and make them skeptical about less validated prescriptions. In the Ghanaian situation the Ministry of Health can undertake the task of providing the information for rural people to meet their health needs.
Proposed Health Information Provision within the
The goals set to be achieved by the Ghana Ministry of Health are outlined in a master document which outlines general reform plans for the country26. Among other strategies, government policy supports empowering households and communities to take more responsibility for their health in a decentralized management structure which emphasizes Primary Health Care. Some of the requirements for delivering such rural and peripheral services close to the people, in practice, include the availability of trained and motivated health care staff with appropriate communication skills. However, the document is not very clear on how to create a unit which would train technical staff to disseminate health care information to the rural people. The closest programme to such an information component in the health reform plan is an establishment for Health Education and the Directorate of Herbal medicine. Information professionals in these units are commonly librarians who disseminate information through printed media which is unsuitable for illiterates.
Recent studies indicate that information is transferred effectively to illiterates through group discussions, teaching, apprenticeship and, story telling27,28 , and at places where people meet, for example, market places, health centres, village meetings, and churches. Workers in the health ministry who by virtue of their work, already teach or advise rural people through verbal communication can provide health information services to rural communities and the urban poor. Especially, workers from the medical field department, primary health care, and community health units reach out to rural communities regularly, and can undergo training to acquire skills to disseminate information. The Education Unit of the Ministry of Health and the Directorate for Herbal Medicine would select personnel who have successfully completed their courses in the above mentioned departments for attachment training as information professionals at the traditional health centres. Thus centres of research into traditional medicine would also operate as information centres where indigenous and exotic knowledge systems would be linked to create new knowledge. These information professionals would work with modern medical research specialists, herbal pharmacists, medicine men, community elders and the common people, to exchange ideas, and identify, extract, and develop useful health care knowledge. Through person to person verbal communication indigenous health knowledge would be extracted and scientifically analyzed. Some of the indigenous health practices are common knowledge to the community but must be subjected to scientific research because of risks known to be associated with them. A case in point are herbs used to induce abortion. Among the women in many rural communities, the use of certain herbs to prevent pregnancies is very common. This knowledge is also spread by peddlers, and, teenage girls who adopt the practice sometimes end up with serious adverse effects. Many cases have resulted in deaths but the inability to give birth in later years probably stands out as the most common effect.
Knowledge created at the centres must be recorded, organized, and disseminated, to professional colleagues elsewhere as well as the general public including illiterates. An observed problem with indigenous knowledge is that it is not written down and as a result it is not properly organized. Pearce reports that in some traditional cultures some people are specially trained to live under spiritually controlled conditions so that they can commit knowledge to memory and recollect and supply the needed information should the need arise29 . Even under these special conditions, recollection cannot be accurate due to memory loss and other factors, and information supplied might be inaccurate. In the Ghanaian situation, the evidence indicates that peddlers receive no training on storage and recollection of oral information. Indeed many peddlers buy and sell the drugs from the traditional centres and have no knowledge about traditional healing.
When knowledge is written down, no one needs to retain it in memory and it can be referred to at any time when needed. Dissemination to illiterates who are the subject of discussion would require repackaging to produce health education materials. Education materials, for example, posters have been used by the Ministry to explain how diseases like HIV/AIDS are transmitted and prevented. In this instance, the education materials would be explaining traditional medical practices which are wrongfully taught by peddlers. Apart from education materials, oral communication would be the main method of transferring the knowledge from the centres to the rural and urban illiterates. Unlike the peddling business the process would take the normal form of outreach programmes mounted by community nurses, primary health care personnel, and the medical field units. Thus, during exercises to create awareness of how to control communicable diseases, or at community meetings where nurses teach environmental health and personal hygiene practices, information about indigenous medicine would be disseminated. Information to be disseminated should include highlighting side effects of common herbal medicines, the dangers associated with certain health practices, problems associated with self medication and correction of any other errors which have been revealed by research at the centres. The immediate aim is to discourage reliance on peddlers and encourage seeking informed advice from competent practitioners.
Perhaps the most effective method by which to get close to the people is through repackaging the information with the help of information technology. Cinema, radio, and television are already familiar and can make the work easier. In addition, there is abundance evidence to support the view that electronic networks and digital storage and transfer technologies, have greatly increased possibilities for information transfer and communication on both North-South and South-South axes30 . Many other studies indicate that the Internet can provide new information sources and new communication channels for rural communities where people are dispersed and other means of communication are either impossible , too ineffective or costly31 . Richardson32 confirms that the Internet can create mechanisms that enable bottom-up articulation and sharing of local knowledge.
The idea is that if each centre can afford a computer and obtain Internet access, then all the centres can cooperate in a network. The most practical arrangement would be to set up networks of terminals in village meeting places. With suitable software and equipment, it is possible and indeed easier to plan and deliver visual presentations, which can be projected onto large screens which illiterates would understand more than the printed poster. Files of the educational presentations can be created at one centre and sent to all the terminals in the network. Websites can be developed for presentations in various topics and accessed from terminals located in the rural communities. There would surely be training implications in computer literacy for the information providers. Experience shows that the use of the Internet can be grasped without too much effort by people who have never used the computer. In the University of Namibia, for example ,it takes only a two hour lecture and an hour hands on demonstration for new students to learn how to search the net. It is speculated that the information professionals in question can be taught and similarly become computer literate, to be able to retrieve presentations files and play slide shows to disseminate information to illiterates.
Indigenous health knowledge provision in developing countries
The situation in Ghana which also applies in other indigenous societies shows that the recognition and integration of traditional medicine into mainstream health systems have produced more knowledge which circulates orally and freely in the community. More research is needed to find out how the knowledge of traditional medicine is reproduced, and verified before peddlers pick it up. Information providers described in this paper would be able to identify the very common ailments treated by traditional healers, and work out disease definitions which can be scientifically classified. For example, during his research into the Techiman-Bono (Ghana) ethnomedical system, Dennis M. Warren33, recorded 1,266 names of diseases in Bono-Twi, 524 of which serve as synonyms for diseases whose primary term was taboo in general usage (such as leprosy or tuberculosis). Classification of local disease names would facilitate communication with the illiterates and thereby provide more reliable knowledge for researchers, traditional healers and the people.
Peddling may not be as aggressive in other indigenous societies as in Ghana but the problem of misinformation and abuse of traditional knowledge is widespread. The important issue is to recognize that indigenous medical knowledge is created by the people and forms part of their way of life. It is therefore the responsibility of governments to ensure that this heritage of the community is not exploited and sold back to the detriment of poor, ignorant people. More important, the knowledge should not be sold back in a form designed to cheat the ignorant and enrich charlatans. Indigenous health knowledge contributes to making the rural and urban poor self reliant and the need to update this knowledge cannot be overemphasized.
Conclusion
This paper has attempted to show that some of the major challenges facing indigenous health information provision in rural and urban poor communities of developing countries have to do with developing systems of interaction to establish rapport with illiterates and their cultural beliefs, locating information dissemination in the national health system, and assisting the development of new knowledge and skills to emerge from practice. It has also become clear that there is the need to define a new identity of the health information professional consistent with the developmental role health care is called upon to play. Health information disseminated to rural and urban illiterates must add to as well as update what the people already know. The non-print approach of communication based on repackaged information from the research output of the centres of traditional medicine, and publications held in libraries or resource centres can be enhanced by modern information technology, in particular, the computer and the Internet.
Peddlers can easily obtain the repackaged information and deliver useful health care service to the rural communities, but if their activities are not supervised, quacks can infiltrate their rank and file and exploit the ignorant through artful misrepresentation of indigenous knowledge. The Ministry of Health in Ghana and similar institutions in other developing countries, in similar circumstances can modify the existing training programmes of some of their departments to produce health care professionals who can undertake information provision for rural and urban poor illiterates. The paper makes the call for dissemination of updated indigenous health care knowledge on a continuous basis as a way of satisfying the needs of rural communities in all developing countries. Providing accurate health care information for rural people is as important as the recommended drugs and other interventions needed to solve their health problems.
References.
1. Correa, Antoinette F., Ndiaye, Djibril, Mchombu, Kingo J., Rodriguez, Gloria M., Rosenberg, Diana, & Yapa, N.U. Rural information provision in developing countries : Measuring performance and impact. [Paris] UNESCO. 1997. Chapter 2.
2. Tsey, K. Traditional medicine in contemporary Ghana: a public policy analysis. Social Science and Medicine 1997, 45 (7), 1065-1074.
3. Murray, Last & Chavunduka, G.L. (eds.) The professionalisation of African medicine. Manchester, Manchester University Press, 1986. Chapters 5, 6, 7 & 11
4. Islam, Anwar & Wiltshire, Rosina (eds.) Traditional health systems and public policy: Proceedings of an International Workshop. Ottawa, International Development Research Centre, 1994. Session 3.
5. Pearce, Tola. Professional interest and the creation of medical knowledge. In: Murray, Last & Chavunduka, G.L. (eds.) The professionalisation of African medicine. Manchester, Manchester University Press, 1986. 245.
6. Ohene, A.C. Experts announce multi-billion dollar bonanza plant research. The Ghanaian Chronicle on the web 2000, 8 (73). URL http://www.ghanaian-chronicle.com
7. Twumasi, Patrick A. Colonialism and international health: a study in social change in Ghana.Social Science and Medicine 1981, 15B (2), 147 - 151
8. Kufuor, Kwame Addo Enhancing traditional medicine practice. Africa news service; Durham [Electronic Document]. URL http://library.avu.org/cgi-bin/LIBgate?pr...
9. Osei-Hwidie, Kwaku. The indigenization of social work practice and education: Vision or vanity? : Inaugural lecture delivered at the University of Botswana on 25 September 1996. Gaborone, University of Botswana, 1996. 3.
10 Brachott Committee Report. Accra, Government of Ghana, Ministry of Health, 1961.
11. Easmon Report. Accra, Government of Ghana, Ministry of Health. 1966.
12. Mensah-Dapaah, K. Traditional healing. Ghana Journal of Science 1968. 21 16-21.
13. Villod, M. T. & Guerin, N. Why rehabilitate traditional medicine? Children in the tropics. 1979 122 13-33
14. Woods, C. M. Alternative curing strategies in a changing medical situation. Medical Anthropology 1977 3 25-53
15. Twumasi, Patrick A.& Warren, Dennis Michael. The professionalisation of indigenous medicine: A comparative study of Ghana and Zambia. In: Murray, Last & Chavunduka, G.L. (eds.) The professionalisation of African medicine. Manchester, Manchester University Press, 1986. pp117 - 135.
16. Neumann, Alfred K. Planning health care programs in a pluralistic medical context: The case of Ghana. In: Yoder, Stanley P. (ed.) African health and healing systems: Proceedings of a symposium 1982 p.219
17 .Mabawonku, Iyabo Health information provision to semi-urban people in Oyo State, Nigeria: What role for library and information centres. African Journal of Library, Archives & Information Science 1998, 8 (2) p.128
18. Twumasi, Patrick A. Improvement of health care in Ghana: Present perspectives. In: Yoder, Stanley P. (ed.) African health and healing systems: Proceedings of a symposium 1982 pp203-204
19. World Health Organization. The promotion and development of of traditional medicine.(technical Report Series 622), Geneva, WHO, 1978.
20. Mensah-Dapaah, K. Traditional healing. Ghana Journal of Science 1968. 21 16-21.
21. Root-Bernstein, Robert & Root-Bernstein, Michele. Honey, mud, maggots and other medical marvels: The science behind folk remedies and Old Wives' tales. London, Macmillan, 1999. pp 231 - 232
22. Machona, Goodson. Life and features: African Potato. The Post Tuesday Edition 1999. [Internet Forum article] "Health-L [Zambia]" health-l@hivnet.ch
23. Kufuor, Kwame Addo Enhancing traditional medicine practice. Africa news service; Durham [Electronic Document]. URL http://library.avu.org/cgi-bin/LIBgate?pr...
24.Murphy, Dean E Africa's silent shame; Rape is spreading AIDS to young children. The trend is fueled by unscrupulous 'healers' who suggest that having sex with a virgin can cure the disease. The Los Angeles Times Aug 16 1998 [Web Article] URL. Http://library.avu.org/cgi-bin/L...22+1+T+1.2.840
25 Root-Bernstein, Robert & Root-Bernstein, Michele. Honey, mud, maggots and other medical marvels: The science behind folk remedies and Old Wives' tales. London, Macmillan, 1999. pp 231-233.
26. Republic of Ghana. Medium term Health strategy: Towards vision 2020, Accra. Government of Ghana, 1995.
27. Correa, Antoinette F., Ndiaye, Djibril, Mchombu, Kingo J., Rodriguez, Gloria M., Rosenberg, Diana, & Yapa, N.U. Rural information provision in developing countries : Measuring performance and impact. [Paris] UNESCO. 1997. Chapter 2.
28. Rosenberg, D. B. Repackaging scientific and technical information for illiterate and semi-literate users: a case study of the Southern Sudan. In: Standing Conference of Eastern, Central, and Southern African Librarians 1987 pp8-22
29. Pearce , T. O. Social change and 'modernization' of the medical sector. In: Afonja, S. A. & Pearce, T. O. (eds.) Social Change in Nigeria London. Longman, 1984.
30. Technical Centre for Agricultural and Rural Co-operation African, Carribean, and Pacific States, European Union. The role of information for rural development in ACP countries: review and perspectives: proceedings of an international seminar Wageningen, 1996.
31. Adeya N. Beyond borders: the Internet for Africa. Convergence. 2 (2): 23-28.
32. Richardson, D. The Internet and rural development: Opportunities for forestry. Unsylva, 1997 189 (48) 3-9
33. Warren, Dennis M. The Techiman-Bono Ethnomedical system. In: In: Yoder, Stanley P. (ed.) African health and healing systems: Proceedings of a symposium 1982: pp88 - 89.