Homeopathy: The Nigerian experience

 The Federal Republic of Nigeria is a country in West Africa occupying an area of 923,768 square kilometers with a population of over 120 million.[ ¹ ] Nigeria is a member of the Commonwealth, Organization of Petroleum Exporting Countries (OPEC), and the United Nations.[ ² ]

The practice of Homoeopathic medicine commenced in Nigeria in the early 1960s.[ ³ ] Nigeria witnessed unorganized homoeopathic groups that engaged in unregulated practice. In 1979, the few well meaning homoeopathic practitioners who had studied abroad came together under one umbrella group. This gave birth to the ‘All Nigeria Homoeopathic Medical Association’ (ANHMA), which was in 1980 duly registered by the Federal Government as legal entity under the Lands (Perpetual Succession) Act Cap.98 Laws of the Federal Republic of Nigeria. This body then established the Nigerian Institute of Homoeopathy as its educational wing for postgraduate members. Meanwhile, no Nigerian University taught homeopathy in its Medical school. The Medical schools were (and still are) exclusively for the orthodox/allopathic training, where homeopathy got mentioned in passing as an outdated therapeutic method based on some funny theories. The orthodox/allopathic doctors also made their patients believe homeopathy to be the same as the prevalent traditional herbal practice, just as they believe naturopathy to mean just herbalism.[ ⁴ ] This erroneous belief and concept of homeopathy did not go down well with the few homoeopathic doctors that formed the umbrella association—ANHMA. The ANHMA mounted pressure on the Federal Government to recognize homeopathy as in developed countries and fully integrate the practice into the mainstream of the nation's health care delivery system.[ ⁵ ]

This pressure mounted resulting in the constitution and inauguration of investigative panels including that which, in collaboration with the British Council, led to the invitation of Dr Peter Fisher, a British Homoeopathic Experts of the Royal Homoeopathic Hospital, London to Nigeria. The panels completed their various assignments and made recommendations in favour of homeopathy.[ ⁶ ] The result of this joint effort was the inclusion of homeopathy in the Medical and Dental Practitioners (Amendment) Decree Number 78 of 1992, and the subsequent registration of the Nigerian Institute of Homoeopathy as a corporate entity by the Federal Government in 1994.

The inclusion of homeopathy in the Medical and Dental Practitioners Decree notwithstanding, the erroneous concept of homeopathy continued with the homoeopathic doctors being often dragged to court on various frivolous charges, although the courts usually found them innocent based on the fact that homeopathy is a widely established and proved school of medicine.[ ⁷ ] These erroneous concepts include the linking of homeopathy with traditional herbalism/occultism and the branding of homoeopathic remedies as placebo, discarding the concept of energy in the medicine. The dominating influence of orthodox/allopathic doctors over other forms of medical practice in Nigeria, and the gullibility of the citizens who believe virtually everything they hear from the orthodox doctors, hindered the implementation of the amended Decree.

In order to ensure the training of homoeopathic doctors in Nigeria to acceptable universal standards, two institutions affiliated to overseas universities. The Nigerian Institute of Homoeopathy (NIH) affiliated to Open International University Sri Lanka for the award of Bachelor's degree and postgraduate qualifications in Homoeopathic medicine, and Luminar International Institute for Health and Alternative Medical Sciences affiliated to the Open International University for Alternative Medicines, India, for the award of Bachelor, Masters, and doctorate degrees in various branches of alternative medicine including homeopathy. Also, instead of full integration, the Medical and Dental Council has a representative for alternative medicines (including homeopathy) and the Federal Government approved the establishment of Nigerian College of Alternative Medicine with its Teaching Hospital (National Hospital of Alternative Medicine). The Luminar International Institute for Alternative Medicine has also been approved as a branch of the Nigerian College of Alternative Medicine. These new developments gave rise to the formation/registration of a body known as the ‘National Association of Physicians of Alternative Medicine’. ANHMA became part of this association and affiliated to the International Homoeopathic Medical Foundation (with headquarters in India) in 2005. No Nigerian University is directly offering homeopathy as a course of study/specialization in medicine.

Practitioners of homoeopathic medicine face the uphill task of treating their patients homeopathically and teaching them the right concept of this form of medicine. Our experience shows that a positive attitude and the right concept of homeopathy can be developed in these patients by spending time to educate them on the historical background, the basic principles and safety of the remedies. Since patients were used to the polypharmacy of the orthodox/allopathic system, the use of one medicine at a time was difficult and we sometimes made use of placebo until the patient got to know more about homoeopathic system. For instance, it would be futile telling a patient with fever that no medicine should be taken before or during the attack. For such a patient, the use of placebo when no medicine is needed bridges the gap and stops the patients from hastily consulting another doctor. In cases where initial aggravation was expected, the indicated remedy may be given and, after the aggravation is over and amelioration sets in, followed by placebo which may be taken up to three times a day. The patient may believe the cure came as a result of the doses of placebo as he was already used to taking numerous drugs for several days in the allopathic system. In some chronic cases where the first dose of the simillimum would relieve a patient's symptom, and the patient had been visiting orthodox clinics to no avail, they are better satisfied if they get cured after taking the medicine over a long period of time. In such cases, giving placebo for the first 2 weeks before the real medicine would bring more satisfaction to the patient as he gets relief from the administration of the simillimum.

Experience has also shown that the way a physician presents homeopathy determines its acceptance, and the level of the patient's literacy should be considered in the choice of words and extent of explanation. To the highly literate presenting what the law says concerning medicine is important. Such a patient should be made to understand that while the law recognizes that there are different schools of medicine, it does not favour or give exclusive recognition to any particular school or system of medicine against the others.[ ⁸ ] The Law postulates that when a patient selects a practitioner of a recognized school he adopts the kind of treatment common to that school, and the question of whether or not a practitioner exercised the requisite degree of care, skill and diligence is to be tested by general rules of the particular school of medicine which he follows and not by those of other schools.[ ⁹ ] A school of medicine, in order to be entitled to recognition under this rule, must have rules and principles of practice for the guidance of all its members with respect to principles, diagnosis, and remedies which each member should observe in any given case.[ ¹⁰ ]

In the case of the moderately educated, qualifying certificates and the institution attended by the homoeopathic doctor matter. A Nigerian University graduate who has a qualifying degree and registration in homeopathy from a University abroad would command the respect and confidence of patients more than a less qualified practitioner. The practitioner's display of the knowledge of allopathy, anatomy, physiology, biochemistry and other basic medical sciences would go a long way to making such patients believe that the practitioner is well qualified. This breeds confidence and such patients accept homeopathic treatment without prejudice.

Illiterates are convinced at the family level and by the fact that their neighbour previously was treated for a serious ailment by the same physician. At the family level, getting the family head or the most literate member of the family convinced builds the confidence of the other members of the family in the physician and his method of treatment.

The motivations that induce young persons to enter the medical profession in Nigeria are prestige, high income, and family tradition. If the erroneous concept of homeopathy is not checked the lack of prestige will deter the young away from the profession. The monopoly of the allopathic/orthodox system could bring about serious lopsidedness in the health sector with the consequent extermination of homeopathy and its rich health benefits in Nigeria.

• References

• 1 McBain FCA. Oxford Atlas for Nigeria. Ibadan: Oxford University Press; 1976, pp 14, 18.
• 2 Lane P. World History. London: Charles letts & Co. Ltd; 1987, pp 145–146.
• 3 Akpa JO. Moving homeopathy and other alternative medicines forward in Nigeria. Homeopathy and other Alternative Medicines News. Enugu, Nigeria: DIEG & Co., 2003, pp 2–6.
• 4 Umobong EA. Green Golds: The Unlimited Wealth from the Plants of Nigerian Forests. Lagos, Nigeria: Emma – Mongs, 2001.
• 5 Katchy PE. Homeopathy, partner in the health care delivery system of the Nation. Homeopathy and other Alternative Medicines News. Enugu, Nigeria: DIEG & Co., 2003, pp 44–47.
• 6 Nzerem DN. NIH Medical College Handbook. Owerri Nigeria, 2000.
• 7 Coleman V. Alternative medicines in the home. The Home Pharmacy. Macmillan Lond. Ltd., 1980, pp 26–29.
• 8 Taylor JL. The Doctor and the Law. London: Pitman Medical Scientific Publishing Co. Ltd., 1970.
• 9 Nathan PC. Medical Negligence being the law of Negligence in Relation to the Medical Profession & Hospitals. London: Butterworth Co. Publishers Ltd., 1957.
• 10 Stetler CJ, Moritz AR. Doctor & Patient and the Law. The C.V. Mosby Company, 1962, pp 305–310.