Volume 10, Issues 2 & 3
Medicine and Anthropology in Twentieth Century
Akan Medicine and Encounters with (Medical)
Abstract: Since the 1920s, there has been a foreground of
fluctuating perspectives on indigenous African medicine and therapeutics in the
medical anthropology of Africa. These circular perspectives in medical
anthropology have stubbornly focused on the ubiquity of "witchcraft," the
natural or supernatural basis of African therapeutics, integration between biomedicine
and indigenous systems of healing, but have failed to excavate African
perspectives on or the relevance of these issues in the background of African
societies. This essay argues the failure to locate African perspectives on
therapeutic matters that may or may not be important concerns in African
societies is the quest for "ethnographic cases" that lend themselves to issues in the field of medical anthropology rather than
African knowledge and perspectives of the field (i.e., Africa). The Bono, an Akan society of central Ghana,
provides but one of many significant case studies in the encounter between
African therapeutics and medical anthropology in the twentieth century, and an
African perspective on the substance of those foregoing issues in the (medical)
anthropology of Africa.
The healer must first have a healer's nature...
[he or she] who would be a healer must set great value on seeing truly, hearing
truly, understanding truly, and acting truly... You see why healing can't be a
popular vocation? The healer would rather see and hear and understand than have
power over men. Most people would rather have power over men than see and hear.
—Ayi Kwei Armah, The Healers, pp. 80-81
In twentieth century
southern and eastern Africa, "traditional" medicine was the dominant healing
system and often regarded as the more appropriate mode of treatment by
specialists and recipients.
Stretching from Ethiopia, Tanzania, South Africa, and Zambia to Cameroon,
Nigeria, and Ghana, indigenous African healing systems remained highly utilized
by large segments of the (rural) populations surveyed. These
perspectives on and use of indigenous medicine were shared by parallel
populations in geographically distinct places such as New Zealand, Hawaii, and
the United States among persons of African ancestry.
Overall, indigenous healers in Ghana and elsewhere rarely translated their
knowledge of medicine into social practices that emphasized the omnipresent
dichotomies of "spiritual" and "natural" disease causation nor did their praxis
revolve around the debates on witchcraft and the existence or denial of African
"medical systems" found in medical anthropology. Akan healers in central Ghana,
and I would suspect elsewhere, were unaware of and perhaps would care little
about the substance of those debates. Since the 1920s, there has been a
foreground of fluctuating perspectives on indigenous African medicine and
therapeutics in the medical anthropology of Africa. These circular perspectives
in medical anthropology have stubbornly focused on the ubiquity of
"witchcraft," the natural or supernatural basis of African therapeutics,
integration between biomedicine and indigenous systems of healing, but have
failed to excavate African perspectives on or the relevance of these issues in
the background of African societies.
This essay argues the
failure to locate African perspectives on therapeutic matters that may or may
not be important concerns in African societies is the academic quest for
"ethnographic cases" that lend themselves to issues in the field of medical anthropology rather than
African knowledge and perspectives of the field (i.e., Africa). This contention is critical for it argues for
a strategic distinction between two sites of knowledge production—field
of medical anthropology and the "field" of Africa where fieldwork is
conducted—on the larger canvas of global health issues using the local
case of the Bono (Akan) therapeutic system of Ghana. Contextually, global
health issues in Africa were conditioned by the failed structural adjustment
and Highly Indebted Poor Countries initiatives of the 1980s and 1990s,
collapsing health structures, the emergence and spread of HIV/AIDS, the global
confrontation between pharmaceutical companies and African governments, and the
lawsuits brought by pharmaceutical multinationals against these governments for
seeking less-expensive drug alternatives. The guidelines issued by the World
Health Organization (purported to ensure the sustainability and safety of the
sixty billion dollars herbal medicine industry) were more than humanitarian as
issues of herbal medicine—poisonings, heart problems, addition of
steroids to plant medicines, poor plant quality and collection
practices—continue to plague the United States, China, and Europe. The
U.S. pharmaceutical industry spent $4.1 billion on drug research and
development in the 1990s and consumers purchased in excess of eight billion
dollars. Since 74 percent of the chemical compounds of the 119 known
plant-derived drugs have the same or related use as the plants they derive,
this pharmaceutical industry exploits medicinal "claims from alien cultures" in
the "discovery" of new drugs. As industries in the United States
and Canada, the European Union, and Japan become more knowledge-intensive, and
"as what constitutes national wealth shifts from the natural resource
endowments toward the acquisition, manipulation, and application of knowledge,"
the ownership and marshaling of indigenous knowledge in and by African
societies have perhaps never been so crucial. In the consideration
of the foregoing, and as the "Western" world extracts African medicinal
knowledge to be brokered between academic and business interests and African
ministries of health perpetuate colonial ideas of "traditional" medicine, the
contention of this essay could not be more timely.
In this essay, I use the
Bono, an Akan society of central Ghana, because they provide but one of many
significant case studies in the encounter between African therapeutics and
medical anthropology in the twentieth century, and an African perspective on
the substance of those foregoing issues in the (medical) anthropology of
Africa. The Bono have occupied an ecological zone between the dense forest and
the savannah and, more importantly, have maintained an ancient and complex
"ethnomedical" and nutritional system since at least the 1000 CE. After
centuries of refinement, the therapeutic basis from which indigenous Bono
healers contemporarily operated were dynamic and often did not function in the
manner prescribed by or constructed in the minds of anthropologists, and
indigenous healers appeared to draw upon a composite spiritual-temporal
perspective in their day-to-day healing work uncluttered by the foregoing
preoccupations in (medical) anthropology. The potentialities of
the indigenous therapeutic system offer an invaluable therapeutic option in
addressing issues of health and healing in Ghana. Moreover, the Bono case
implies that knowledge produced on such systems are less the realities on the
ground than they are the representations of "authorities" who fail to fully
grasp an unmediated picture of healing (in village or urban life) with and
without the presence of the anthropologist, medical doctor, or NGO worker over
time. In the last few decades, the ways in which indigenous (medicinal)
knowledge has been "discovered" by these brokers of knowledge is cynically
remarkable, and the appropriation and reduction of that knowledge for vested
academic and pharmaceutical interests calls into question the vital issues of
representations, authority, causation and therapy dichotomies, and the ubiquity
The (Medical) Anthropologist and the Akan
In medical anthropology, it has become somewhat
popular nowadays to have cultural "conversations" about medicine and healing in
ethnographic representations of those therapeutic "non-systems" studied.
In these ethnographic representations, the ultimate goal is some sort of
negotiation "between the insider and outsider perspectives." Yet, as
this goal or the mode of illness conversations seeks the foreground of healing
discources, vital issues that threaten this very same quest are simultaneously
pushed to the background. Two of these key issues will suffice. First,
relations of inequality and power are glossed over and presented as a given,
that is, white university doctors or professors linked to "established"
educational or medical institutions are supported by grant-giving agencies to
conduct research in African or largely African populated societies in which
enslavement and colonialism are a part of the living fabric and memory.
Whatever research related discussions or conversations occur, they most likely
are "artificial dialogues" configured by the power relations historically
situated, in the broad and multilayered scope of historical encounters, between
the African and the European. The intent here is not to reduce the matter of
research to white power and African subjugation, but rather to remind us that
race (variously defined) is itself ubiquitous in ethnographic encounters in
Africa and its Diaspora and cannot be simply ignored in any serious
consideration of those encounters.
Robert Pool mentions, as one of several constraining
factors, a fragment of this issue of power relations; however, this fragment is
presented as a featherweight contender in the super heavyweight fight of his
conversations about illness. Perhaps, his preoccupation with "witchcraft"
obstructed this issue during his mediated dialogues. Secondly, Paul Brodwin talks
much about the goal of ethnographic research as one of representation between
"insider" and "outsider" perspectives, yet he does not say much about money in
terms of limited options in the availability of biomedicine for most of the
rural population that he studied in Haiti. He also does not say much about his
payment for witness treatments and consultations, which calls into question
what actually occurred during his fieldwork and the dubious picture of village
life he presents. In other words, Brodwin wrote as if he was absent from
village life when his presence alone affected whatever normalcy existed prior
to his periodic arrivals. This is not to suggest that anthropologists have the
power to shift the meaning of an entire medicinal system by their mere
presence, but that the representation of those systems by such researchers is
not the reality they purport but a snapshot conditioned by their foreign
presence and the fulfillment of academic interests. Brodwin's aim, therefore,
appears to have not been one of clarifying the reality of healing in rural
Haiti but rather a convenient ethnographic exercise linked to issues in medical
The emergence and life of a
"Western" anthropological project was more than simply "framed by the
[supposed] superiority of European and American science and industrial
development and by the colonialist context of research." This
project was and is an embodied vehicle of the views and values of those who
desire or claim global hegemony in politico-economic and military terms.
Therefore, as Sally-Anne Jackson argues, nineteenth century imperialism and
biomedicine, which was re-imagined as tropical medicine, were inseparable and
the intimate relationship between disease and empire, in terms of ailing
African bodies constructed as vectors of infection, allowed for African
exploitation and colonial imposition. The diseased African body, cast as
"other" or alien through the introduction of co-colonizing diseases such as
tuberculosis, necessitated the denigration and suppression of "efficient
indigenous healing systems in operation" and expedited the expendability of
those from that "afflicted continent." The very nature of the
"Western" anthropological project strongly suggests that "Western" (social)
science has a direct relationship with European interests and imperialism, and
the global presence of the former is an expression of European expansion. As
such, the proposition "that indigenous/folk/local groups should determine...
their own historical destiny—with the anthropologist as facilitator or
broker"—has been heralded and unquestioned. Even
among those who question this belief, they have also "fail[ed] to escape the
Western hegemonic mentality that they criticize."
In the medical anthropology of Africa, the ideas of
W. H. R. Rivers and C. G. Seligman, both medical researchers who became
anthropologists, have immense implications since the orientation of Rivers'
(1924) work became a widely used model (and some still employ it now) in
"ethnomedical" research. For Rivers, death and illness were defined as
afflictions and misfortune and the study of health and disease was reduced to
his conceptions of witchcraft, sorcery, and magic—conceptions which, no
doubt, were rooted in the long history of witchcraft and related phenomena in
the European experience and imagination. The primary concern was with the
disease—wherein the person was viewed as a diseased organism—and
its magical, superstitious sources in terms of an unyielding obsession with
magical theories of disease causation as the basis for indigenous therapeutic
systems. This same orientation figured prominently in the works of V. M. Turner
and E. E. Evans-Pritchard, Evans-Pritchard's studies, precisely his work on the
Azande published in 1937, became the framework which others have used to fit
their data linked to "witchcraft" in Africa. Evans-Pritchard studied under C.
G. Seligman, who wrote the foreword to his text on the Azande, and in that same
text Evans-Pritchard wrote, in spite of contradictory statements throughout,
"witchcraft is ubiquitous" for "the Azande attribute sickness, whatever its
nature, to witchcraft or sorcery" and secondary causes are "associated with
witchcraft and magic." His study on the Azande might be
oversimplified here, but that study's concern or obsession with witchcraft
parallels those anthropologists before and after him who have had a similar
Evans-Pritchard noted that the "royal class" detested
their European colonizers and "were useless as informants," suggesting that
those who were useful informants were receptive or yielding to European
conquest which surely made a difference in the value and volume of information
obtained during his cumulative twenty month stay among the Azande. The recent
works of British anthropologist Robert Pool, who spent time in the Wimbum town
of Tabenken (Cameroon), resurrected Evans-Pritchard and propagated the model
set forth by W. H. R. Rivers, and his devotees, when he concluded, "in the
final instance everything boils down to witchcraft" in Wimbum and apparently in
African etiology. According to Pool, witches are the
ultimate cause of all (significant) illness, misfortune and death, and given
his acceptance of the long-standing dichotomy between "natural" and
"supernatural" etiologies, he argues that Wimbum etiology is personalistic
("supernatural") and the "Wimbum do not have a medical system" at all.
Based in the Bono town of Bonkwae (Takyiman) during
his study of the Primary Health Training for Indigenous Healers (PRHETIH) project,
Peter Ventevogel also concluded that Akan medicine was not a "real system"
because of its highly externalizing and diffuse character. The
issues of the existence (or denial) of indigenous African "medical systems,"
theories of natural and supernatural or personalistic disease causation and
therapy, and the ubiquity of witchcraft, which undergird the foregoing,
saturates the discourse on African therapeutics and culture. In fact, these
issues have become the discourse in (medical) anthropology.
For the Akan, Robert Sutherland Rattray's collected
works on the Asante, an Akan society, are considered "a monument of colonial
ethnography and manifestly a major source," and are utilized as one of several
baseline sources for Asante and general Akan studies. In
1921, the then Gold Coast Government chose Rattray as the first head of the
Department of Anthropology. In the capacity of British colonial anthropologist,
he traveled to areas formerly under Asante control and documented aspects of
socio-political organization and indigenous "religious" life.
Rattray's work focused on the Asante and, in the several chapters dedicated to
festivals and Bono "religious life" in Takyiman, he, like his anthropological
predecessors, went in search of the "gods" and even requested that one be made
for him to take home to Britain. Rattray did not attempt to explore
the indigenous medicinal system nor its conceptual underpinnings. Instead, he
contended that religion was inseparable from other facets of life and regarded
the Takyiman area as a place "hitherto untouched by the anthropologist and
hardly opened up to the European, [and which] should be the ideal ground upon
which to study Akan customs and beliefs"
In the 1930s, Margaret J. Fields, a British colonial
anthropologist intrigued by the new "witchcraft" shrine movement in Ghana,
spent time at the Bono town of Mframaso (20 miles north of Takyiman) at a
"witch-catching" shrine. She generalized from this experience and concluded,
"According to African dogma sickness and health are ultimately of supernatural
origin" and "organic illness is almost always attributed to witchcraft, bad
medicine or sin, seldom to worry and stress." In the latter part of
the 1960s, Dennis Warren came to Takyiman as a Peace Corps science teacher at
the Takyiman Secondary School. Warren later conducted his doctoral study on
Bono "disease, medicine and religion" and concluded the "religious system" had
nothing to do with the majority of Bono disease lexemes or Bono diseases, which
were conceptual, and that the vast majority of Bono diseases were defined in
terms of natural causation. Warren's argument here and elsewhere
for "natural" rather than "supernatural" disease causation marked a shift from
previous anthropologists, but only formed part of the fluctuating or circular
contentions in anthropological understandings of African disease causation and
therapy. Warren found that the most serious and common diseases were linked to
the stomach, head, and malaria, and the highest-ranking causes were associated
with (impure) blood, dirt and a dirty body, and insects (e.g., germs and
mosquitoes). The anatomical location of most diseases were in the skin or
internal; disease prevention strategies included eating good food, a clean
living environment, drinking good water, and bathing twice a day, while the
most frequently named medicines and ingredients consisted of ginger, varied
peppers, water, and lime. The baseline data for Warren's study
derived from nearly 1500 "disease names organized into a 12-level taxonomic
system expressed by one venerated Bono priest-healer [Nana Kofi Donkor]."
The data gathered from Nana Kofi Donkor was compared with data from other
informants within the same community; this approach used more than one
informant as a reliability check on initial and primary informants, "the most
important being Nana Kofi Donkor of [Takyiman]." In
addition to the construction of his disease classificatory scheme, Warren
argued that spiritual causations of disease do occur but naturally caused
diseases did not have structural or functional relationships with Bono
"religion" (what he termed Onyamesom), hence, his dichotomy between "spiritually and naturally caused
Peter Ventevogel, who conducted his studies on the
effects of the PRHETIH program, argued, "the literature on Akan medicine lacks
real consensus on the indigenous nomenclature of nutritional diseases. [and]
indigenous disease names cannot be substituted unproblematically by Western
disease terms." The PRHETIH program was established
in 1979 as a project to "train" indigenous healers in some of the fundamental
techniques employed in the biomedical system. The project collapsed in 1983 and
was later revived in 1991. Evans-Anfom commented that the outcome of an
evaluation of the PRHETIH program "should help in determining how trainable the
traditional healers are." Interestingly, Evans-Anfom neither
considered nor questioned how "trainable" were biomedical practitioners, who
appear to be hegemonic and the most hostile toward attempts aimed at
"cooperation" (whatever that means). In sharply criticizing Warren, Ventevogel
It became clear to me that the
indigenous knowledge is not readily available in the minds of the informants,
ready to be 'discovered' by the anthropologist. The Techiman-Bono ethnomedical
classification system can be seen as an attempt to formalize a system that is
not formalized in its nature. Akan traditional medical knowledge is not a solid
body of knowledge. It differs from town to town, from healer to healer, from
day to day. Akan medical knowledge is partially idiosyncratic and is embedded
in an externalizing medical system.
Ventevogel's study compares well with those of Robert
Pool, and both noted the few key informants used by Warren and argued that the
anthropological understanding of indigenous knowledge was produced and
reproduced in an interplay between informants, interpreter, and researcher.
However, their conclusions were at odds with those of Helga Fink, who studied
in a Bono area but whose work drew heavily on Warren's dissertation and
classificatory scheme, and Van Dalen, whose study in a Bono town revealed that
disease was always the effect of certain natural and spiritual happenings
rather than spiritual or natural (causative) factors. In challenging G. P.
Murdock's dichotomy of natural and supernatural theories of illness causation
and Pool's assertion that "everything boils down to witchcraft" in African
ethnomedicine, Edward Green, a colleague of Warren, attempted to advance his
indigenous contagion theory with the claim that major (contagious) diseases in
African societies are naturalistic or impersonal.
Green, Warren, Van Dalen, Fink, Ventevogel, Pool, and others, no doubt, follow
a long tradition of anthropological dichotomists who have argued for either
side of the natural-supernatural coin, or claim the coin itself is worthless in
their verdict on African medicinal systems, systems long regarded as synonyms
On "Witchcraft" and the
Many African nations "still
retain Witchcraft Acts promulgated during the colonial era," and in Botswana,
for instance, its "witchcraft proclamation" aimed at "diviners" rather than
herbalists was passed in 1927 and remains in legal force. On this
historical phenomenon, the discourse on "witchcraft" in the African context is
often silent as a pragmatic and ideological consideration in ethnographic
"conversations" about illness and therapy. The resuscitation of Evans-Pritchard
recently by Robert Pool, among several others, argues that there is no such
thing as African medical systems since everything in those non-systems are
ultimately embedded in and explained by "witchcraft." In
Bongmba's attempt at an interpretation of the phenomenon of "witchcraft" among
the Wimbum—in one of whose towns Pool conducted his study—he notes
the conceptual and contextual translation difficulties surrounding the Limbum
terms of bfui, brii, and tfu
employed to differentiate the varied phenomena consolidated under the term
"witchcraft." The fact that the Wimbum and perhaps
other Africans have come to use non-Limbum vocabulary from other parts of
Cameroon as well as English terms, such as witchcraft and sorcery, in their
"attempt to make sense of what it means to be human" in a capitalist and
homogenizing global order suggest the "borrowed" use of "witchcraft" is no more
than semantical or misappropriated nonsense.
Though Bongmba criticizes
what he considers to be Evans-Pritchard's imposition of Azande thought in terms
of epistemological superiority, it was writers such as Eva Gillies who
concluded that the Azande or other Africans do not attribute diseases to
witchcraft or sorcery for these "actors" make distinctions between different
kinds of illness and between levels of etiology and pathogenesis.
Even those who argue that "beliefs and practices related to medical care
should be subsumed under the domains of religion, magic or witchcraft," while
contemplating Evans-Pritchard's contribution to polemic debates on rationality,
have merely created ideational structures conducive to their own thinking and
offering such creations as the reality. In Murdock's global
survey of the ethnographic literature using criteria derived from medical
science and anthropology, he found that witchcraft was "practically universal
in the Circum-Mediterranean region but surprisingly rare elsewhere in the
world." According to Murdock, this region
includes "Caucasoids," "the Afroasiatic, Indo-European and Maro-Sudanic," and
is distinct from the "region of Sub-Saharan Africa" offering "essential
confirmation to a single region" based on overwhelmingly high witchcraft
ratings. "Witchcraft," Murdock wrote, "is
important among about a third of Africa's peoples but is absent in about half
of them." These findings offered by
Murdock—however flawed by his creation or use of the above "ethnic
clusters" and his reliance on studies which largely sought the exotic and
supernatural—sketches a picture that does not support the "ubiquity of
witchcraft" or that everything in African etiology boils down to "witchcraft"
Among the Bono, the
discourse on "witchcraft" finds little solace but rather an opportunity for
("witchcraft") is a power or energy with intent used positively or negatively,
and writers often translate it as "witchcraft" (the act itself). Abayisem as well as the Fante ayen is also employed, and the former refers to
"witchcraft" or (a)bayie matters,
issues, and cases (nsem).
According to Akator, bayie
derives from the phrase ebeye yie
("it will be good or all right"); if this is the case, then we must reconsider
the exclusive "witchcraft" connotation the term obayifoo (pl., abayifoo; one who does bayie)
seems destined to have. The phrase, according to Akator, is
an optimistic utterance made to give hope and direction for one who needs to
consult the obayifoo. In the Bono
area of Takyiman, abayi-bonsam is
the male "witch" who does or uses bayie, while obayifoo, a
gender-neutral term that applies to either sex, is used for the female. The
(female) abayifoo usually
outnumber the abayi-bonsam, and
the abode of the obayifoo is in
the female line of the family where the most damage occurs among the obayifoo's own blood relatives.
The idea that abayifoo are powerless outside of their own clan, possess an
organizational structure akin to Akan polities, and desire and feed on blood
suggest that abayi is a metaphor
embedded in, yet antithetical to Akan social order, which is rooted in the abusua (mother-centered family or clan) itself synonymous
with mmogya or blood.
One may never know who is an obayifoo, even the obayifoo
themselves—as one may be born this way or do the work of an obayifoo unconsciously. Nana Kwasi Appiah, one of my
informants, argued that "witchcraft" was inborn or inherited with a capacity
for positive ends, but it is the person's mind or the factor of intentionality
that shapes bayie into something
negative. Confessions by abayifoo are usually made after they have been caught by one
of many "abayifoo-catching" obosom ("spiritual agents" or "emissaries" of an Akan
Creator) called obosombrafoo
(pl., abosommerafoo). If an obayifoo does not confess, they are spiritually executed by
the obosombrafoo prior to a
warning of some sort to elicit a confession. The confession appears to be
cleansing and medicinal, and akin to the Akan protocol involved in greeting
someone: though the person may live next door, he or she must state his or her
"mission" or intent for visiting in order to cleanse the social space and
prepare it for positive interaction. A confession, though perhaps stating the
obvious to others in a way similar to a neighbor stating why he or she is
visiting, may operate within the same line of reasoning as the Akan greeting
Nonetheless, there was a
shift from the tete abosom (ancient Atano abosom) to the increased popularity of abosommerafoo in the late nineteenth century and first half of the
twentieth century. This shift corresponded to (a) the
decline of Asanteman (Asante nation) in the late nineteenth century and British
colonial imposition; (b) instability in Akan society largely occasioned by
colonial rule; and (c) the upsurge of what became the cocoa industry, which
facilitated the rise and popularity of the abosommerafoo, the majority of which came from northern Ghana and
Burkina Faso. The spread of the abosommerafoo paralleled the spread of migrant workers who came
from northern Ghana, Burkina Faso, and elsewhere. In 1879, cocoa plants were
successfully cultivated in the Akwapem area of Ghana's Eastern Region. The Gold
Coast government took control of this industry by 1890. The cocoa industry's
emergence led to not only sharp declines in palm and coffee products, but also
occasioned one of the most crucial changes of the twentieth century in Akan
(and Ghanaian) society. Thousands of farmers became prosperous and created
tremendous income gaps between them and the urban professionals, subsistence
farmers, and underemployed migrant laborers.
The outward expansion of the
cocoa industry from the Akwapem area caused a migration of farmers who sought
new lands for cocoa trees and cocoa regions depended on tens of thousands of
migrant laborers who came from northern Ghana, Burkina Faso and elsewhere.
The increase in the use of abosommerafoo, such as the Tigare obosom
from Yipala in northern Ghana, mirrored the increase in the cocoa cash crop
that brought heavy social tensions as many farmers cultivated this crop and
challenged the social structure that provided security for its members.
Major socio-economic changes usually alter a society's disease patterns, and
the expansion of cocoa farming in southern Ghana provided a stimulus for
opening roads and clearing forestlands for agriculture, which further
facilitated the breeding of the mosquito that is the major vector of falciparun
malaria. The logic that industrialism,
economic growth, and increased living standards produces better health
conditions, as suggested by Patterson, seems problematic and inconsistent.
As Patterson himself notes, with urban growth there has been a decline in human
life and health, and with higher incomes consumers could choose nutritious
foods or white bread, sugar, tea, tinned milk (for infants), and other
foodstuffs of dubious value. The phenomena of deforestation and
commercial lumbering, which began in the 1880s, allowed sunlight to reach pools
of water creating favorable breeding conditions for malaria-carrying
mosquitoes. Though the above transformations presented specific challenges to
indigenous healers and their practice, the Bono have maintained an allegiance
to their ancient Atano abosom
despite the shifts in Akan society and spiritual practices, and still regard
the obosomfoo as senior to the okomfoo. The obosomfoo attends to the abosom and provides healing services, and, in this
matrilineally inherited but male position, he oversees the "shrine" attendants, including the
gender-neutral role of ]—another category of indigenous healers. The abosomfoohene ("head obosomfoo) for Takyiman "state" obosom Taa Mensa (Tano Mensa; "Taa" is the contraction of
"Tano," as in the Tano River) has a position of authority above all individuals
inclusive of the Takyimanhene ("male leader of the polity"). This social
configuration and the role of its spiritualists in healing individual and
community ailments suggests a strong concern with order and balance, including
those that use bayie (so-called
"witchcraft") for nefarious ends, and this concern forms part of larger
perspective on indigenous medicinal knowledge and its dimensions and
Akan Perspectives on
African Medicinal Systems
In reducing African
medicinal systems to "witchcraft," global readers and Africans consume such
anthropological or colonial renderings of those systems and, invariably, fail
to appreciate the layers of indigenous (medicinal) knowledge possessed by
various members of a community and the ideational basis of the systems'
approach and therapy. In the Bono therapeutic system, there exist key spheres
in production, transmission and deployment. The three primary and overlapping
spheres include those at the level of core and basic knowledge, specialized and
in-depth knowledge, and peripheral knowledge. The first sphere corresponds to
the core-basic knowledge shared
by most, if not all, community members and the basis upon which those members
plan and do. Here, "core-basic" refers to what is fundamental and widely known
within the indigenous medicinal system, and at an essentially basic level of
knowledge and aptitude, though there are those who are an exception to this
general observation. For instance, a "majority of the population [still] prepare and use their own
herbal mixtures," and thereby exhibit agency in the process of addressing their
health needs. Informal interviews among the youth
of Takyiman found that they were very knowledgeable about many medicinal plants
and their functions, in addition to revealing the names and utilities of at
least six of the most effective and frequently used medicines cited by indigenous
healers in the Takyiman district.
The second sphere
corresponds to specialized and in-depth knowledge that is associated with the
specialists who function ultimately to maintain the coherency and expand the
development of the community as it principally relates to holistic health and
healing. Those specialists were the indigenous healers who represent the
institutions of abosomfoo, akomfoo, and nnunsinfoo ("herbalists"). Almost all of the indigenous healers interviewed
agreed—with the exception of one who qualified her response—that
there was a clear distinction between nyansa (wisdom) and nimdee (knowledge). In terms of the procedural relationship
between wisdom and knowledge, wisdom was older than knowledge and one could not
acquire knowledge without wisdom. However, it appeared that knowledge was
considered heavier or more substantial than wisdom for reasons that one was
born with the capacity for knowledge but knowledge had to be learned and
developed, and thus it grew, accumulated, and became "heavy" as a result of
one's journey through life.
The third and last sphere of
peripheral knowledge refers to information about a people's existence at varied
points and events in their lives. This sphere is "static knowledge" that lacks
the dynamism or "lived" characteristic of the core-basic and specialized and
in-depth spheres, and archives
aspects of the first and second spheres similar to how a camera captures the
image of a person or event. The picture only re-presents a finite moment in the life of that person or event,
and clearly is not the person or event; nor can the picture attempt to embody
the person or event as a living entity or experience. The picture merely
archives that finite moment, which, interestingly, in and of itself, may
contain a vast amount of information and insight well beyond the moment that it
visually captures. Numerous narratives or kind of information can potentially
be preserved within a single photo or another documenting and archiving
mechanism. Yet, even photos and archiving mechanisms spoil, corrupt, or even
corrode over time, hence, acknowledging their inherent limitations. This
peripheral knowledge, although significant, has been the nature of all
(medical) anthropological writings, and the still pictures they have purported
in the field and documenting media of anthropology must always be (re)evaluated
in juxtaposition to the "core-basic" and "specialized" knowledge in the fields
The above spheres of
indigenous medicinal knowledge all share an ideational basis that further
questions the ubiquity of "witchcraft" proposition and the common
anthropological understandings of African therapeutics. The ideational basis of
indigenous African medicine suggests a holistic approach to balanced health and
other human circumstances and this basis considers the variables of family, way
of making sense of the world, vocation, ecology, and cultural environment while
placing a high value on the human being. In one of Mandeng's
interviews with an elder healer in Cameroon, that healer explained, "the living
and the dead, we all live in the same world." Instructive and
simple are these healer's words, yet the dichotomization in the theories of
African illness causation and treatment well represented in the literature remain
quite pervasive. If this dichotomy were an academic
journal, it would appear from the literature that many writers have active or
perhaps lifetime subscriptions in terms of buying into the supposed
"naturalistic" and "personalistic" explanations of disease and the therapeutic
strategies deployed. A few have constructed three
categories of illness causation, namely, natural, preternatural, and
supernatural to explain the parallel physical, "magical," and
"ritual-sacrifice" dimensions of each respective category, while most have
remained vigilant on the natural-supernatural antagonism.
Guided by the belief that
the anthropologist's first task is "to find the simplest taxonomy for causality
beliefs" and that to "depersonalize causality" reflects an "evolution of
culture," Foster, among others, argued the principal etiologies of "non-Western
medical systems" were personalistic and naturalistic in nature.
Painted on a neat canvas as irreconcilable opposites, these two primary
etiologies have been criticized as "inappropriate and unnatural
categorizations" undermining "a more emic approach," and as "enormous
reduction" that fails to examine health and sickness ideas "as they are in the
usually exigent context of social action." Moreover, the
naturalistic-personalistic dichotomized model is deficient not only in terms of
addressing how practitioners and patients conceptualize illness and therapy,
but in terms of also explaining health behavior and perceptions in situations
where multiple health systems are utilized by members of a given society. If a
society does not distinguish what researchers call "separate levels of
reality," then why do these same writers present that society in terms of
"natural" and "supernatural" worlds? The main idea which emerges then from
the varied perspectives riddled by the natural-supernatural dichotomy is that
complexities of life, whether health related or not, are often crudely forced
into one generalization or another without regard for the ways in which real
people approach and resolve health and healing circumstances during their life
Pervasive or not, the
dichotomization of African societies and the ideational basis of their
therapeutic systems are commonly unrealized in the praxis of indigenous Bono or
Akan healers. Accordingly, one can say, "Both the
organic and the spiritual aspects of the disease are taken into consideration.
[and that the human being] is a compound of material and immaterial substances,
which makes the maintenance of a balance between the spiritual and material in
[humans] a condition for sound health." However, to
correspondingly claim, "[t]he practice of medicine is closely tied up with the
practice of religion in Africa," confuses indigenous concepts of medicine and
healing through the use of the alien variable of "religion" with its untangled
linguistic and cultural baggage. The Bono ideational approach to
healing is based on a composite spiritual-temporal perspective rather than a
"religious" grounding, and that perspective is found in other African
societies. For instance, the Bântu-Bakôngo notion of n'kisi ("medicine") is complemented by the concept of
"self-healing power" as "the biogenetic package of power that is received at
the moment of conception in the mother's womb." This
package is not only the key to one's health, but it is the excellent healer
since it is both creative and generative. For the Bântu-Bakôngo, sickness is
the abnormal functioning capacity of one's self-healing power caused not by
bacteria or virus, but by the loss of the body's balance or energy.
The cure is perceived in terms of wholeness and the therapist (n'niâkisi or m'fièdi) "believes that therapy is essentially grounded in both flesh and
spirit," a process of restoring self-healing power. In
Nigeria, Offiong concluded, "It seems proper to assume that religious [i.e.,
spiritual] factors are intrinsic to healing." In the Ivory Coast,
Memel-Fotê found that—among the Mande, Gur, Kru, and Akan—the
comprehensiveness of indigenous medicine was characterized by "its broad
conception of health, sickness and cure, itself linked to the idea of life,"
and indigenous "medical theory [was] that man's nature is not only physical but
also mental and spiritual."
Noticeably, Ghanaians have
been described as "ambiguous" with confused attitudes towards indigenous
(medicinal) systems and Western (medical) institutions because of the "fatal
impact of irreconcilable social systems and cultures." This
ambiguity is a cultural and ideational phenomenon, and its powers compel even
academic "authorities" in Ghana to proclaim, "it is for us scientists to throw
the light of science on the herbalist's art, and lay a more pragmatic and
scientific basis for his practice." This pronouncement is not an anomaly
for it is wholly consistent with others that passionately declare, "healing
with herbs cannot continue to be just an art" since "African methods were
wholly trial and error." Many of these scholars, however,
fail to either recognize or accept that there has always been a demystified
"scientific" process to indigenous medicine in addition to the vast knowledge
of medicines acquired through close observation of nature and animals'
application of those medicines, trial tests on animals and sometimes humans,
and practical experience accrued over centuries. More
importantly, it is the misguided pronouncements of Ghanaian scholars on the
issue of indigenous medicine and the gestation and propagation of "witchcraft"
driven anthropological understandings of "traditional" medicine that provided a
dubious setting for current debates of "integration" or "cooperation" between
indigenous and biomedical systems.
Some have argued struggles,
resistance, adaptation, critique, negotiation, and appropriation have
characterized the encounters between indigenous and "Western" medicine, but
these processes have all reduced indigenous systems to "things."
Correspondingly, individual herbs were objectified through "Western" analytical
concepts, bio-chemical analysis, randomized clinical trails, creation of
patents for bio-chemical substances, and marketing those substances as drugs
and nutritional supplements. In this context, the debate with regard to the
"integration" of indigenous therapeutic systems (specifically their varied
categories of healers) into national health delivery systems in Africa remains
a discourse captured by seemingly irreconcilable ways of thinking, cultural
behavior, and sensibilities. Irrespective of the argument that
the distance between "Western medicine" and "non-European folk medicine is a
product of post-nineteenth century medical science," the lives of African
people are decisively affected by the contestation that exists between the two.
Given that African ministries of health and medical schools still propagate
colonial attitudes towards indigenous healers, and missionary and government
school curricula nurture those perceptions, it is not surprising then to find
ambiguity harbored in the minds of Ghanaians, and the Akan in particular,
especially with regards to matters of indigenous healing. Part
of this ambiguity is itself rooted in the ways in which colonial rule both
heightened so-called "witchcraft" tensions, altered disease environments, and
affected the search for and value placed upon viable therapeutic options.
At the turn of Ghana's
political independence in the 1960s, a leading anthropologist among the Bono
(Akan) argued, "the introduction of Western institutions has not resulted in
conflict between culture or between 'traditional' and 'modern' segments of
culture, but rather in accommodation." Warren's perspective,
and other anthropological understandings of indigenous medicine, facilitated
the first of several integrative health projects and shaped the "integration"
of indigenous healers with biomedicine in Africa. In the 1970s, Ghana was one
of the first to host health initiatives such as the Damfa project funded by
USAID in Greater Accra, the Brong-Ahafo Rural Integrated Development Project
(BARIDEP) project funded by the World Health Organization (WHO) and the Swedish
International Development Cooperation Agency (SIDA) in the Kintampo district,
varied United Nations Children's Fund (UNICEF) sponsored training projects, and
the Primary Health Training for Indigenous Healers (PRHETIH) project which
operated between 1979-1983 in the Takyiman district.
Several projects of a similar nature were initiated in the Bono inhabited
districts of Berekum and Dormaa based upon the PRHETIH experience and the film
initially entitled Bono Medicines
(1983) and later renamed Healers of Ghana (1996). Many indigenous healers who participated in the PRHETIH program
soon discovered the "one-way" nature of PRHETIH as well as analogous efforts
(e.g., the Damfa project). This realization was confirmed by project
facilitators who noted how sessions on herbs were the best received while those
sessions that "consisted primarily of advice or description" were least
The above experiences have
engendered multiple arguments and proposals. Some argue that integration is
pragmatically impossible but some form of cooperation in areas where both
indigenous and "Western" medicine complements each other is feasible. Others
propose that integration or collaboration could lead to a reconciliation of the
unsettled encounter between indigenous African and "Western" medicines and the
cultural frameworks in which they are embedded. In other words, the renewed
interest in and debate about the integration of indigenous medicine and
"biomedicine" has its origins in and is a synonym for the historic encounters
between adherents of both approaches to health and healing. Integration or not,
African governments continue to place demands on indigenous medicine to "go
modern" by way of scientific rationality, some biomedical doctors recognize
healers as potential allies in the fight against AIDS, and pharmaceutical
companies and similar agencies exploit indigenous medicinal knowledge (through
intellectual property rights conventions) under the auspices of
Perhaps the barriers to
integration are in fact substantial and the benefits are unproven, as some have
argued. Proposals to provide on-the-job
training for young health professionals with indigenous healers, for public
education to rectify the popularized false perceptions of indigenous medicine,
to utilize indigenous healers as part of a global disease reporting systems for
emerging diseases, and to create a two-tier medical school system may be
missing a vital point. The conjuncture of views and
propositions on integration or collaboration suggests what is really at work is
a recasting or reduction of indigenous medicine as a mechanical, lifeless, and
inhuman adjunct to biomedicine with a "one-size-fits-all" approach that neglects
the fact that physiologically, emotionally, spiritually, and ideationally no
two human beings are the same. In effect, indigenous medicine will become like
biomedicine and since we are dealing with "two different medical paradigms," as
Hedberg and Straugård observed, integrative attempts to compartmentalize the
"empirical" and the "spiritual" and, subsequently, disregarding the latter will
only engender an inadequate version of "modern medicine." In
this context, Foulkes' contention that indigenous African medicine is a system
that is "irreconcilable with our own" (i.e., "Western" or "bio-medicine") seems
more intelligible though there are those who believe that there is
compatibility "in the domain of contagious disease."
Surprisingly, the relatively high levels of collaboration among indigenous
healers themselves in places such as Cote d'Ivoire —Ghana's western
neighbor and home of several Akan groups—do not form part of the
discourse nor do they figure in proposals for health projects in African societies.
Rather than efforts to further collaboration and efficiency among indigenous
healers who serve much of the general populace, we are left incarcerated by the
idea that "traditional healers are a poorly organized group of people with only
a low formal education, and therefore cannot be regarded as equal partners with
Western health care workers who are well trained and embedded in powerful
institutions." Lastly, one cannot simply imitate or
import, in the African context, the stories of "integration" between
"traditional" and "biomedical" specialists in the Asian countries of China,
Vietnam, and Singapore.
The way the "cooperation"
discourse is framed, indigenous healers and the medicinal system they represent
are problematized—that is, there is a problem "training indigenous
healers" and integrating them into the biomedical system. In that framing,
"cooperation" or "integration" is never stated as a process of creating a new
system wherein both participate on agreed upon terms or that biomedical workers
"integrate" the indigenous system, particularly if that system represents and
is responsive to the overwhelming majority of the population. Rather, the
"cooperation" or "integration" debate has been unilateral with the biomedical
system being both the source and the destination; this situation has been
glaringly demonstrated by the health projects initiated in several Bono
districts. It would seem more sensible to "integrate" into a indigenous system
that is embedded in the thought and pragmatic structure of society than to do
the same with an external (and antagonistic) system, such as the biomedical
one, which is imported and removed from the majority of the people, and only
accessible to a few financially well-off, urbanized individuals. This debate, however
framed, appears to be a distraction from the real issue: the inherent and
unbalanced power relations embedded in society, and the marshaling of human and
other resources towards the substance of people's lives. It is not that unequal
power relations make therapeutic pluralism impossible, but that very social
arrangement, often evident in widening socio-economic disparities, does not
marshal the same levels of resources to support indigenous therapeutic options
used by large parts of the citizenry.
At the cultural or ideational level, both the
indigenous and the biomedical systems are irreconcilable at their very core.
The notion of "integration" seems misguided and the idea of "cooperation"
(whatever that means) appears more feasible if both systems acknowledge and
accept their areas of expertise and limitations, perspectives and cultural
foundations from which they operate, and are genuinely concerned about the
difficult but necessary task of being human. The fact is medical training in
Ghana and other parts of the world traditionally focus on disease diagnosis and
management rather than on preventative medicine and health promotion. The
lesser focus on preventative medicine and health promotion has historically
constituted the very underbelly of biomedicine. It appears, therefore, serious
introspection for biomedical systems existing in Africa is an imperative before
any pragmatic consideration toward cooperation or collaborative efforts between
those systems and indigenous ones. In rural Haiti, the competing ideologies of
Catholicism and Protestantism unite and consolidate their assault toward Vodun
adherents and specialists as their "demonic inverse," and yet, Haitians
continue to seek out and utilize the latter's therapeutic services.
In Ghana and other parts of Africa, the collaboration between the truncated
nation-state and its political and medical instruments engaged in their own
assault through policy, propaganda, and resource misallocation. Yet and still,
the cultural views and values of its vast majority, particularly rural
dwellers, as well as many "educated," "un-schooled," and Christian or Muslim
individuals alike seek out the therapeutic services of indigenous healers.
These peoples negotiate socio-political circumstances as best as they can
through what they know, and it has become clear to me that their
intergenerational knowledge has not brought them this far because it is solely
or most importantly hinged on the fear of "gods" and the nocturnal activities
"medical knowledge is not a thing or a fact, it is the outcome of a historic
process," and postulated, "constructing an 'ethnomedical' system resembles
taking a snap-shot of a certain place at a certain time."
Though Ventevogel's notion of a "snap-shot" lends itself to our discussion of
peripheral sphere of indigenous knowledge (i.e., capturing what exists in a
delimited historical and cultural context), he is really insinuating that the
Akan medicinal system is not what it was a hundred years ago nor will it be the
same a century from now. The boundaries of what constitutes "Akan medicine" are
becoming blurred. However, Minkus's findings on Akan medicine twenty years ago,
Maier's findings from the literature related to Asante (Akan) medicine almost
two centuries ago, and what eighteenth and nineteenth century writers observed
on the Gold Coast (contemporary Ghana) still holds true among many Akan
communities. This does not mean Akan medicinal
knowledge is static or resistant to refinement, but has been one of continuity
in medicinal practices aligned with spiritual-temporal convictions held over
the centuries. The boundaries of what constitutes "Akan medicine," as opposed
to Mossi or Dagomba medicine, are sometimes not easy to discern because of
movement, interaction, and incorporation of varied skills and techniques
related to health and healing. This development, however, reveals the
significance of the Bono cultural and ecological zone as a point of (medicinal)
knowledge convergence among varied African societies and implies an internal
pan-African knowledge base among West Africa therapeutic systems—a
development borne of historic processes in the "field" of West Africa.
Out of historic processes
and encounters also came the fluctuating and, at times, divergent, perspectives
on the "naturalistic" or "supernatural" basis of African therapeutic systems
in medical anthropology and a reduction of those systems to an ubiquitous
"witchcraft." I have argued this development came out of a continuous failure
to locate African perspectives on the substance of such realities in African
societies, and that failing emerged from a quest for "ethnographic cases" and
issues of "witchcraft" and "supernatural" etiologies in the field of medical anthropology rather than the
field of African knowledge and
perspectives. Our discussion has placed that failing and its importance into
proper and broader context. In so doing, this essay also sought to clarify some
of significant realities linked to health and healing in Akan societies and
since these societies were sites of "integrative" health projects for several
decades, those realities contributes a valuable perspective on issues of
"witchcraft," disease causation and therapy, and on the integration or cooperation
debate in medical anthropology. An Akan perspective on those issues suggests a
strategic distinction between two sites of knowledge production—field of
medical anthropology and the "field" of Africa where fieldwork is
conducted—on the larger canvas of global health issues. Such a
distinction revealed "witchcraft" was more ubiquitous in the anthropological
literature than in the "field" of Africa. Anthropological approaches to and
understandings of indigenous medicine constructed the "integration" debate and
the key factor of incompatibility. The medical anthropology of Africa will
remain constricted by its history unless it exorcize its obsessive quest for
supernaturally charged medicines, magic, gods, and witchcraft.
Rukangira 2001, p. 180.
Bishaw 1991; Gessler et al. 1995;
Puckree et al. 2002; Rukangira 2001, p. 180; Stekelenburg et al. 2005, p. 78;
Mandeng 1984, pp. 3-4; Betti 2004, p. 3; Osujih 1993; Offiong 1999, pp. 128-29;
Ekpere and Mshana 1997, p. 2.
Toafa et al. 2001; Bell et al. 2001;
Marbella 1998, p. 184; Payne-Jackson and Lee 1993, p. 3.
 "biomedicine" and its variants
(e.g., biomedical, allopathy, conventional medicine) refer to the use of
biological, biochemical, physiological, and other basic "scientific"
assumptions to address issues in clinical medicine, particularly as it relates
to an almost obsessive focus on the body as a biochemical contraption that is
the source and site of disease or sickness
 See Farnsworth, 1988.
 Brodwin 1996; Pool 1994a.
 Brodwin 1996, p. 194.
 Jackson 2003, pp. 3-5.
 Purcell 1998, p. 260.
 Pfeifer 1996, p. 47.
 Evans-Pritchard 1937, pp. 63, 479.
 Pool 1994a, pp. 108-112, 254, 264.
 Ventevogel 1996, p. 136.
 McCaskie 1983, p. 187.
 Rattray, 1923, pp. 5-10.
 Rattray 1923, pp. 172-87; see also
Platvoet 2000, pp. 80-96.
 Rattray 1923, p. 114.
 Field 1960, pp. 112, 117.
 Warren 1974, p. 431.
 Warren 1974, pp. 299, 343, 357.
 Ventevogel 1996, p. 132.
 Warren 1974, pp. 95, 431.
 Ventevogel 1996, p. 95.
 Evans-Anfom 1986, p. 58.
 Ventevogel 1996, p. 137.
 Green 1999, pp. 17, 37.
 Makhubu 1998, p. 40; Hedberg and
Straugård 1989, p. 22.
 Bongmba 1998, p. 166.
 Feierman 1985, p. 108; Gillies
1976, pp. 358, 391-92.
 Morley 1979, pp. 2, 8-9; Foster
1976, p. 773.
 Murdock 1980, p. 21.
 Ibid., pp. 43, 45-46, 52.
 van der Geest 1984, p. 60; Murdock
1980, p. 8.
 Brempong 1996, p. 44.
 Rattray 1927, pp. 28-29.
 Appiah, K. Interview by author.
Nyafuman (Takyiman), Ghana, 25 December 2001.
 Silverman 1987, p. 285.
 Patterson 1981, p. 103.
 Ibid., p. 7. The Gold Coast
government in 1947 established the Cocoa Marketing Board, which determined the
optimal conditions for producers, fixed prices locally and for distribution to
the world market, and appointed agents who bought cocoa from farmers on behalf
of the board. The board was or currently is the only authority to market cocoa
outside of Ghana and the Kwahuhene is the head of the board.
 Ventevogel 1996. Tigare is both a suman and an obosom, and the latter is a more recent
development according to traditions found among the Bono. According to oral
historical sources, Tigare was a suman used primarily by hunters, as a hunter found it in
the forest, and as a suman it did not "possess" its custodian. A Tano obosom extracted clay from the Tano River,
in addition to other ingredients, and placed the composite substance on the
transforming it to an obosom.
 Patterson 1981, pp. 1-4.
 Konadu 2007, pp. xx, 53-57.
 Warren 1974, p. 325.
 The spheres of indigenous medicinal
knowledge detailed here also exists in other African and African-descended
societies, such as those in Cameroon, Ghana, Tanzania, and Haiti, and among
healers in the Bolivian Andes and Amazon. See Betti 2004, p. 3; Dokosi 1969, p.
119; Mandeng 1984, pp. 4-6; Swantz 1990, p. 11; Brodwin, 1996, pp. 2-3;
Vandebrock et al. 2004, p. 838.
 Bishaw 1991, p. 199; Memel-Fotê
1999, p. 328; Mandeng 1984, p. 247; Appiah-Kubi 1981, p. 148.
 Mandeng 1984, p. 245.
 Green 1999; Murdock 1980; Warren
 Muela et al. 2000; Green 1999;
Bierlich 1999; Gyekye 1997, pp. 245-46; Ventevogel 1996; Gbadegesin 1991, pp.
128; Fink 1990; Swantz 1990, pp. 143; Warren and Green 1988, p. 6; Mandeng 1984;
Warren 1982, p. 89; Fosu 1981; Morley 1979; Foster 1976.
 Foster 1976, pp. 775-776.
 Foulks 1978, p. 660; Kleinman 1978,
 Ventevogel 1996, pp. 132-133; Van
Dalen 1987; Minkus 1980.
 Fu-Kiau 1991, p. 23.
 Offiong 1999, p. 129.
 Memel-Fotê 1999, p. 328.
 Assimeng 1999, pp. 246-247.
 Addae-Mensah 1992, p. 49.
 Addy 2003, p. 31; Addae 1996, p.
 Offiong 1999; Ventevogel 1996; Good
1987, pp. 17-18; Anyinam 1987; Evans-Anfom 1986, pp. 43-62; Pillsbury 1982;
Rappaport and Rappaport 1981; Twumasi 1975.
 Meyers 1976, p. xii.
 Assimeng 1999, p. 246; Nakuma 1994.
 Warren et al. 1981, p. 18; Warren
1978, p. 77.
 Warren et al. 1981, p. 14;
Appiah-Kubi 1981, p. 148.
 Liverpool et al. 2004;
Yangni-Angate 2004, p. 4; Offiong 1999, p. 128; Gessler et al. 1995, p. 158;
Twumasi 1988, pp. 26-27; Warren et al. 1981.
 Barrett et al. 2004, p. 258.
 Groce and Reeve 1996, p. 352;
Nakuma 1994; Appiah-Kubi 1981, p. 148.
 Hedberg and Straugård 1989, p. 29.
 Foulkes 1992, p. 122; Green 1999,
 Memel-Fotê 1999, p. 333.
 Ventevogel 1996, p. 123.
 Brodwin 1996, p. 193.
 Ventevogel 1996, p. 135.
 Bosman 1967 , pp. 224-225;
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is Assistant Professor of History at The City University of New York. He is the author of Indigenous
Medicine and Knowledge in African Society (2007) and A View from the East: Black Cultural Nationalism and
Education in New York City (2008).
Reference Style: The following is the suggested format for referencing this article: Kwasi Konadu, "Medicine and Anthropology in Twentieth Century
Africa: Akan Medicine and Encounters with (Medical)
Anthropology," African Studies Quarterly 10, nos. 2 & 3: (Fall 2008) [online] URL: http://africa.ufl.edu/asq/v10/v10i2a3.htm