History of Public Health in Nigeria - An overview ...

History of Public Health in Nigeria - An overview ...



The concept of Public health has existed before the scientific coining and definition of the term. The issue of disease and health is as old as man. The African local communities have several indigenous and traditional ways of responding to disease conditions. Preventive and curative practices were in place in various Nigerian communities before the coming of the colonial masters. While some of these are still being practiced today owing to their effectiveness, some have been redefined or upgraded in the context of modern public health practice. 

Definition of Public Health

Public health is the science of protecting and improving the health of families and communities through promotion of healthy lifestyles, research for disease and injury prevention and detection and control of infectious diseases. Overall, public health is concerned with protecting the health of entire populations. These populations can be as small as a local neighborhood, or as big as an entire country or region of the world. However Winslow (1920) gave what could be described as comprehensive and robust definition of Public health as ―the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community efforts for the sanitation of the environment, the control of community infections, the education of the individual in principles of personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of disease, and the development of the social machinery which will ensure to every individual in the community a standard of living adequate for the maintenance of health. 

It is therefore obvious that public health does not only include actions taken to prevent development of diseases, but timely diagnosis , treatment and rehabilitative measures taken to prevent progression of diseases, reversal of communicability and limit disability. It is against this backdrop that public health could embrace aspects of curative and rehabilitative medicine. History of public health in Nigeria therefore should embrace historical efforts aimed at evolving or developing preventive and curative services for the purpose of improving and sustaining Health. 


Context of Public Health Practice in Pre-Colonial/Traditional Nigerian Society

Health even before the coming of the colonial masters has been known as the most precious of all things and the foundation of all happiness. Traditional medicine has developed in various communities in Nigeria in response to the health needs of the people. Many communities have, therefore, since creation, developed various traditional systems using locally-available resources for the alleviation of their health problems. Besides, many rural communities have great faith in traditional medicine, particularly the inexplicable aspects as they believe that it is the wisdom of their fore-fathers which also recognizes their socio-cultural and religious background. The development of traditional medicine in Nigeria has led to various categories of healers, the various healing methods, strategies and medicines or remedies now known.

Although this traditional system of health evolved separately in different micro-cultures, there is a great deal of philosophical and conceptual similarities. The origin of diseases in Africa was simplistic. It is either an enemy had cast a spell on somebody or one is being punished by divine powers for his sins. In the same sense disease preventive practices could be associated with regular rituals and sacrifices made to ancestral beings, family and community deities and are believed to help in warding off calamities including illness and sicknesses dominantly thought to be associated with evil spirit activities.

Categories of Practitioners/Practices in Traditional society

Various categories of the practitioners include:

Herbalists

Herbalists use mainly herbs, that is, medicinal plants or parts of such plants to cure diseases. Traditional Birth Attendants (TBAs) These TBAs occupy a prominent position in Nigeria even till today as between 60-85 per cent of births delivered in the country and especially in the rural communities are by the TBAs. They assist the mothers at childbirth based on skills initially acquired to past participation in child delivery.

 Traditional Surgeons

These function in the cutting of tribal marks, male and female circumcision (Clitori dectomy).These functions they carry out with special knives and scissors; blood-letting operations etc. The wounds that result from these operations is usually treated with local procedures such as snail body fluid or pastes prepared from plants. They also remove whitlows.

Traditional Bone setters

Traditional bone setting is recognized to have attained a level of success comparable to that in orthodox medicine in Nigeria. The skill tends to run in families or lineage as practioners tend to hand the practice over to their children or trusted relations who continue with the practice after their death.

Practitioners of Therapeutic Occultism (Spiritual healers)

These include diviners or fortune tellers, who may be seers, ―alfas‖ and priests, and use supernatural or mysterious forces, incantations, may prescribe rituals associated with the community's religious worship and adopt all sorts of inexplicable things to treat various diseases. In some cases it may involve consultation with ancestral spirits, community deities and water spirits.

More so Preventive practices such as Isolation cannot be said to be foreign to Nigerian indigenous communities as Individuals known to be suffering from dangerous and contagious diseases such as leprosy were known to be isolated in secluded environment where they are kept incommunicado with other members of the community. Certain norms guide the maintenance of adequate sanitation in the communities. For instance, women and children, particularly the girls, sweep the homes/surroundings and empty refuse bins.

There are also cultural festivals that emphasize cleanliness in various communities and many such festivals still persist till today.

Public Health which could be seen as ―the science and art of preventing disease, prolonging life, and promoting physical health and efficiency through organized community and Governmental efforts, cannot be said to be an entirely new concept that was introduced by the colonial masters, but various aspects of it has been in practice before the onset of colonization.


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