A chronological account of the history & progress of naturopathy in Ghana

Introduction

The emerging field of Naturopathy is gradually gaining ground in Ghana and sub-Saharan Africa as a whole. Even though the profession is not fully structured and properly regulated as it should be, some great strides have been taken by some pioneering persons and organizations, and this has a huge tendency to influence the future and extent to which Complementary and Alternative Medicine (CAM), specifically, Naturopathy progresses. Thus, this paper presents a commentary and review of some literature on the chronology of Naturopathic practice within the Ghanaian health system.

In Ghana, currently as a CAM modality, the history of Naturopathy is anchored under the umbrella of the Traditional and Alternative Medicine Practice Council. In Ghana also, herbal medicine is more accepted partly due to the passage of Act 575 in 2000. Naturopathy was dormant under the umbrella of Alternative Medicine. The Traditional Medicine Practice Act 2000, Act 575 is the Legislative Instrument (LI) that regulates Traditional Medicine (TM) practice in Ghana.1 Though Act 575 mandates extend to the practice of alternative medicine, the Act is completely silent on alternative medicine and only emphasizes traditional medicine. This creates some kind of ambiguity in Act 575 to extend its mandates to alternative medicine, though traditional and alternative medicine is siblings.

On the other hand, before the adoption of Act 575 in 2000, the interest of the government was then to propagate traditional medicine. This led to the formulation of the Traditional Medicine bill and its subsequent passage into law in 2000. Though the Traditional Medicine Practice Act was passed in 2000, the secretariat for the council was set up in 2004 to adequately prepare the ground for the Council. In a critical analysis of Act 575, the preamble states that:

“AN ACT to establish a Council to regulate the practice of traditional medicine, to register practitioners and license practices, to regulate the preparation and sale of herbal, medicine and to provide for related matters” 2

Before the establishment of the Council, the Ministry of Health, Ghana, started with the establishment of a Traditional and Alternative Medicine directorate to prepare the grounds for the Council. The directorate’s role is completely different from the Traditional Medicine Practice Council, which deals with practice and education. This Directorate3 ensures the availability of technical expertise and guidance in all processes in the development of policies, plans, regulations, standards, programs, and projects for the Traditional and Alternative Medicine sub-sector of the Ministry. One of its three units, the Traditional/Alternative Medicine Policy/Regulations Unit, develops and reviews the broad policies for the Traditional and Alternative Medicine sub-sector of the Ministry. It designs and develops Traditional and Alternative Medicine licensing and regulatory schemes, mechanisms, systems, plans, strategies, and standards to regulate activities within the sub-sector. The directorate is currently led by Dr. Anastasia Yirenkyi.

The Traditional Medicine Practice Council was officially set up after the successful implementation of the Traditional and Alternative Medicine Directorate. According to the Ministry of Health,4 the Traditional Medicine Practice Council was eventually constituted and inaugurated on the 9th of April, 2010. The vision for the Council states: “To be an internationally acclaimed regulatory agency for Traditional and Alternative Medicine practices”. The Mission statement states: “To promote, control and regulate Traditional and Alternative Medicine practices by formulation, implementation, coordination, monitoring and evaluation of policies and programs and thereby contributing to the national development agenda”. The council was headed by the immediate past Registrar, Torgbuiga Yaka IV.

Section 6 of Act 5752 also deals with the appointment of committees. There is a Standard Setting and Ethics Committee that deals with setting standards and ethical issues in the practice of traditional medicines. There is also the Educational Committee, which also deals with accreditation issues and training in traditional medicine. There are calls on the Ministry of Health to separate alternative medicine from traditional medicine, to allow alternative medicine gets its council to help streamline the industry. Others have also called for a new ministry for Traditional and Alternative Medicine which should be independent of the Ministry of Health as in the case of India, the AYUSH ministry.5

According to the WHO (2019) report, data shows that between 2004 to 2006, population use for T&CM practices was about 1–19% for acupuncture, ayurvedic medicine, chiropractic, homeopathy, naturopathy, osteopathy, therapeutic massage, traditional Chinese medicine, and Unani medicine. Herbal medicines were also used by 80– 99% of the population.6

Legislation Challenges

The challenge with the Traditional Medicine Practice Act 2000, (Act 575) is its silent stance on alternative medicine and its emphatic position on traditional medicine. On the other hand, the challenge is understandable as, before Act 2000, the Government worked with the Ghana Psychic and Traditional Medicine Practitioners’ Association to license and register traditional medicine practitioners and to ensure a standard of care.

This has created a lacuna, though successive governments have recognized both traditional, complementary, and alternative medicine. The definition of who qualifies to be called a Traditional Medicine Practitioner in the Ghanaian jurisdiction7 is a subject for debate. For instance, Section 42 which deals with the Interpretation2 states: that "practice" means that traditional medicine practices;

"practitioner" means a traditional medicine practitioner whose practice uses herbs and any other natural products; ''traditional medicine” means practices based on beliefs and ideas recognized by the community to provide health care by using herbs and any other naturally occurring substances. From the review of the Act, it is straightforward to recognize the many lacunae in the Act2 and needs extensive amendment after twenty (20) years of promulgation. For instance, if one juxtaposes this interpretation of the meaning of ‘alternative medicine’ under Section 21 of the interpretation of the Nigerian Medical and Dental Practitioners Act CAP M8, which deals with the practice of medicine, dentistry, and alternative medicine in Nigeria,8 It states: “Alternative Medicine” means naturopathy, acupuncture, and osteopathy; (1992, No. 78.)”. The Nigerian position on alternative medicine is clear and not ambiguous.

In Ghana, there are practitioners such as Naturopathic doctors, and chiropractors who in the Ghanaian system cannot be regarded as Traditional Medicine Practitioners if one takes inference from Act 575.2 These prompted policymakers to introduce a new bill on alternative medicine to amend the Traditional Medicine Practice Act 575. The new draft bill defined ‘alternative medicine’ as any system of medical practice outside the jurisdiction of traditional and Conventional or Mainstream medicine.7 This new bill finally brought some clarity between Traditional and Alternative Medicine in Ghana. The bill further captured nutritional supplementation as well.

As it stands, the Ministry of Health3 Policy Guidelines on Traditional Medicine development state that, “An Alternative Medicine Bill is yet to be passed in parliament”.

Interestingly the acting President of Ghana Alternative Medicines Practitioners Association (GAMPA) Dr. Albert Arthur, called for the passage of the Traditional and Alternative Medicine bill which had been shelved for far too long.9 explained that the Traditional and Alternative Medicines bills were prepared separately in the same period, but the Traditional Medicines Bill had been passed leaving the Alternative Medicines Bill.9 stated that the Traditional Medicine Law was a restrictive one that regulated only traditional medicines, so after a decision to merge the two bills, GAMPA had been working towards the passage of the merge-bill (Traditional and Alternative Medicines) since 2012 but had not seen the light of day. The new bill if passed would officially provide statutory regulation for alternative medicine in addition to the existing traditional medicine.

Insurance coverage

Private organizations provide the health insurance under which indigenous TM is covered. As of 2012, other T&CM practices were partially covered by both Government agencies and private organizations. Partial private coverage is available for chiropractic, herbal medicines, naturopathy, and traditional Chinese medicine. As at end of 2016, T&CM services were not reimbursed by public health insurance according to the WHO.6

Early Pioneers of Naturopathy

Early fathers (1960-1999)

Interestingly, Naturopathy was practiced way back in the 1960- 1970s. The type of Naturopathy practiced then was traditional Naturopathy. The first Naturopath then was one late Dr. Bruce who died, we were, told in the 1970s. His naturopathic facility was located at Korle-Bu. He became famous for his handling of medical cases from the Korle-Bu Teaching Hospital. After his death, his son who also took his practice passed in the 1970s.

Another Naturopath by the name of Dr. John Agrippa Nartey also gained popularity in the 1980s. His naturopathic facility was located at the Nsawam in the Eastern Region of Ghana. The third Naturopath we chanced on is Dr. Afram. Dr. Afram we were told was sponsored by Dr. Kwame Nkrumah to the United Kingdom to study Naturopathic Medicine to gain knowledge, return to Ghana and teach Naturopathy. Unfortunately, his mission was truncated after the late Dr. Kwame Nkrumah was overthrown. After his return, he established his Naturopathic facility at Adabraka in the 80s.

One Dr. Siderway was a key promoter of holistic medicine in the 1980s. He was a Lebanese and Ghanaian. Due to his educational background and the unattractive nature of alternative medicine at the time, he joined the Traditional Medicine fraternity. He, at a point, became their Public Relations Officer. He was later poached to join the Ghana Alternative Medicine Practitioners Association (GAMPA). He started some training programs in holistic healing. We were told he died a painful death.

Most of the early Naturopaths such as Dr. Bruce and Dr. Nartey were Osteopaths as well. They however neglected the practice of Osteopathy as the Medical doctors focused on and recognized only Physiotherapists in Ghana. They became frustrated and passed on.

In 1992, Dr. Ba-Lagi Gregory Lugo-Zuri, another Naturopathic Doctor emerged and was honored by Pope John Paul II. He has been conferred the honorary certificate of "Special Apostolic Blessing and Recognition" for his contribution to medical care internationally.

"I congratulate you on your significant achievements that are worthy of the highest recognition possible," the Pope stated in a citation accompanying the certificate delivered to Dr. Lugo-Zuri in Accra by a Special Envoy on Sunday.13 He was an insurance expert and received training on radionics machines.

Dr. Lugo-Zuri and colleagues formed the Ghana Naturopathic Medical Association and Ghana Naturopathic Medical Council. The challenge was that a council meant they had legal backing, but that was not the reality. The Council was a private entity and a misrepresentation in the field of Naturopathy.14 Dr. Richard Quainoo was another Naturopathic Doctor and director of Agrata Natural Health Centre who emerged in the 90s to the Millennium era.15

In 2007, another Natural Medicine crusader who also became a strong voice for Natural Medicine was Oheneba Ntim–Barimah.16 He started a crusade on things that have been hidden from the Blackman on Rush Hour a segment called “Ahinta Asem” (The Hidden Fact) with his media education background. Oheneba Ntim–Barimah the vegan (strict vegetarian who hates animal food and depends on plant food) started the crusade and was subsequently dismissed from Hot Fm (93.9 Fm). He had no medical background, and nor had he studied Naturopathy. He notes:

“I read and spend money on books and materials the doctor will use. I do a lot of research on herbal materials both visual and audio. Through reading, somebody becomes a doctor, lawyer, and what have you. So I am what I am”.16

He later joined Oman FM and Net2 TV17 to promote his crusade on Natural Medicine and established his clinic Soul Health and Wellness Center9 where he consults.

Figure 1

Oheneba Ntim Barimah, a key natural medicine campaigner.

Modern Naturopathy Development

Professional modern Naturopathic development started in 2016. The promotion and advocacy for Modern Naturopathy surfaced in the system, led by Dr. Raphael Nyarkotey Obu, a Naturopathic researcher. He was a trained Diagnostic Medical Sonographer from Radford University College, Ghana. He also received science Laboratory Technician Part 1 training from Trans Africa University College, Ghana. As a Diagnostic Medical Sonographer and Laboratory Technician in 2010, he worked with a Medical Doctor who trained in Pharmacognosy and was operating an herbal clinic known for Prostate Health. As a sonographer, he developed an interest in urological ultrasound at the herbal clinic. Seeing so many men with prostate issues at the herbal facility, he found the need to further his education. He enrolled to study the first-ever Master’s program in Prostate Cancer introduced by Sheffield Hallam University, UK, and Prostate Cancer UK to train experts in the subject to help men diagnosed with the disease.18 His first paper in the Prostate Cancer program at Sheffield Hallam University, UK, revealed how overreliance on unscientific herbal remedies increased the mortality rate of Ghanaian men diagnosed with prostate cancer.19

During his Master’s Program in Prostate Cancer at the Sheffield Hallam University, UK, he chanced on how CAM is used as part of the quality of life care for men diagnosed with prostate cancer. He developed an interest in CAM and with his strong academic prowess, Dr. Nyarkotey Obu became a powerful voice in Ghana in advocacy, research, promotion, and education of modern Naturopathy. He became a known figure in the prostate cancer advocacy space where he called on the former President John Dramani Mahama to recognize Fathers’ Day in Ghana as a national prostate cancer day.20

He developed an interest in Naturopathy and holistic medicine after his postdoctoral training under the auspices of Dr. George Georgiou, at the Da Vinci College of Holistic Medicine, Larnaca city, Cyprus. He started writing columns21, 22 and scientific articles in the leading Newspapers such as Chronicle,23 BFT,24 Ghanaian Times, Daily Graphic, Daily Dispatch, and many more newspapers to promote Naturopathy. He also educates the public using the radio and television as well as online platforms such as Modern Ghana and Ghana Web21, 22 He also organizes conferences and workshops to teach Naturopathy.23

He took Naturopathy and holistic Medicine to a different level and established the first Naturopathic and Holistic Medical School, Nyarkotey College of Holistic Medicine, at Tema Community, 7, Post office and Ashaiman, behind the Municipal Assembly.25

Figure 2

Nyarkotey college of holistic medicine, ashaiman.

His ability to shape Naturopathy led to his discovery by Vinnytsia State Pedagogical University, Ukraine, a representative in Ghana contacted him which led to his conferment with an honorary Professorship in Naturopathy, and Holistic Medicine, at a relatively young age of 34. This feat led to him becoming one of the youngest Professors in Ghana26 and the first Naturopath in Ghana to be conferred Professorship. This further led the West Africa Nobles Forum to confer on him with the title ‘Noble’ and admitted him into the forum.27

Prof. Nyarkotey shaped Naturopathy in Ghana, even as a student of Master of Business Administration at the Accra Business School, he wrote about the market aspect of complementary medicine.28 Additionally, it didn’t stop at the business school. He continued to Law school to gain legal education. As an LLB Law student at Kings University College, Prof. Nyarkotey was writing law papers on Naturopathy.29

He became well known in his field which made the Herbal Department of Kwame Nkrumah University of Science and Technology (KNUST) finally write to him for stakeholder engagement in Ghana in 2021.30 The team was led by Professor Isaac Ayensu, the new Head of Department of the Herbal Medicine. As part of the team’s visit to Nyarkotey University College of Holistic Medicine and Technology, the college submitted the Doctor of Naturopathic Medicine and Bachelor of Homeopathic Medicine curricula to the head of the department for adoption.

Subsequently, a report titled “A working Visit to Nyarkotey College of Holistic Medicine” was presented on Friday, March 12, 2021, at KUNST herbal medicine department by Dr. Bernard Turkson, Ph.D., which details the team visit to the college and prospective collaboration with KNUST. On Monday, 15^th, March 2021, Nyarkotey College of Holistic Medicine applied to the Ghana Tertiary Education Commission (GTEC), formerly National Accreditation Board, to start the first National accreditation for a degree program in Naturopathic Medicine and other holistic medicine programs.

Homeopathy Activism

The homeopathy movement also started in 1960-1970 just like Naturopathy. Practitioners received their training through the apprenticeship system and others through correspondence. The correspondence schools introduced the homeopathic students to the books once they enrolled. Examination questions were sent down to the students to answer and resubmit to the school for assessment.

The late Dr. Mathew Kyei was instrumental in the homeopathic activism in the 1960s and one Dr. Osei Mensah became Ghana Alternative Medicine Practitioners Association (GAMPA) first President. Formal education was started by homeopathy Without Borders in 2004. They traveled to Ghana, recruited students, trained, and provided them with certifications. The movement led to the formation of the Ghana Homeopathic Association.

The Modern era saw the likes of Endpoint Homeopathic Hospital and Gewah Homeopathic Hospital which also trained many apprentices. They also started formal education in Homeopathy. Some of the institutions could, however, not survive.

Chiropractic Activism

The Chiropractic movement started in November 1990 when Dr. Albert Arthur, Spanish Chiropractic trained, came to Ghana. Dr. Albert Arthur is a big name in the CAM space in the Ghanaian jurisdiction. He was instrumental in many activities that shaped the industry of CAM. He was part of the first and second Ghana Alternative Medicine Practitioners Association (GAMPA), a government federation body of CAM associations. Dr. Arthur is the current acting President of the association and holds the Chairmanship Position of the Registration Committee of CAM Practitioners at the Traditional Medicine Practice Council, Ministry of Health. He set up the Mercedarian Chiropractic Spine Specialist Clinic in Osu Accra.31

Figure 3

Dr. Albert Arthur (2^nd from left with staff at his clinic), the first Chiropractor in Ghana

Dr. Arthur has practiced Chiropractic for over 30 years after graduating from A.C.E.N.A. Malaga Spain, Martyrs Clinic Mamprobi Accra. Dr. Arthur is with a long-standing experience with techniques in correcting complex chronic degenerative conditions of the spine. Backaches, slip disc lumbago, herniated disc, Sciatica, Scoliosis, Slight Scoliosis, pains – frozen shoulder, pains, pulling, weakness, - numbness in the legs. Persistent – chronic headaches and sports injuries.

Post-2000, the likes of Dr. James Bush Jr and Dr. Marcus Mann, both Americans, also joined the chiropractic activism. Dr. James Bush Jr was granted his first interview in Ghana by the Accra Mail in 2001 32 where the meaning of chiropractic was explained to create advocacy with the titled “ Ghana: Chiropractic Comes to Ghana.” This interview drew interest and was also published on the Dynamic Chiropractic website.33

The story reads

“The opening of a chiropractic clinic usually doesn't land a spot in the local newspaper, but when James Bush Jr., DC, opened a clinic in Accra, Ghana, Africa, he was interviewed by the Accra Mail. (Ghana, to save you a trip to the World Atlas, is on the west coast of Africa, tucked between the Ivory Coast and Togo; Accra, the capital, is situated on the Atlantic coast.)

The Accra Mail reporter, A.R. Alhassan, had to explain chiropractic to Mail readers. "It was discovered by curious man," Alhassan noted, "that disease conditions can be imputed to the imbalance in the nervous system, which can be remedied through the manipulation of the spinal column. This is called chiropractic, a science which has been perfected in the U.S."

The reporter witnessed the palpating skills of Dr. Bush, noting the expressions of gratitude from the patient.

"When she turned to chiropractic, she found the relief she longed for," observed the reporter.

Dr. Bush, a Life graduate, hopes to work with hospitals in Accra”.

After Dr. Bush came Dr. Marcus Alan Manns, who received his education in Pre-Med at Virginia Commonwealth University and obtained his Doctorate in Chiropractic from Life University (USA) at the age of Twenty Five.28 He is a fellow of the International Chiropractic Pediatric Association (ICPA), a founding member of the United Chiropractic Association of Ghana (UCAG), and a member of the International Chiropractic Association (ICA). He is also the Founder and CEO of the African Chiropractic Mission (ACM), an NGO and Chiropractic and Wellness Center. Dr. Marcus has been acknowledged as the foremost Chiropractic pioneer on the African continent with multiple awards.34

Figure 4

Dr. Marcus Mann

The late Dr. Olu Akinshemoyin, born to Nigerian Parents in Ghana was also another pioneer in the chiropractic space. He set up Frist Choice Chiropractic.35 He was then the President of the Chiropractic Association of Ghana.36 Others such as Dr. Godfrey Nunoo, a renowned Ghanaian Chiropractor,37 and Dr . Bryan Leon Cox were the latter-day Chiropractors who emerged. Dr. Cox set up the Spinal Clinic.38 The Chiropractic space has two females American and only one Ghanaian female Chiropractor39 trained from Palmer College of Chiropractic, USA.

Figure 5

Dr. Godfrey Nunoo was interviewed in 2010

Dr. Marcus Mann and Dr. Bryan Cox’s success stories were also published on their alma mater website which we republished here:40

“We have two PEAK opportunities in Ghana. The first clinic is Chiropractic Wellness Center which is owned by alumnus Dr. Marcus Manns. Dr. Manns owns five offices in the Accra metropolitan area. His offices not only offer chiropractic care, but also wellness coaching, massage therapy, and nutritional counseling. Dr. Manns has a passion for spreading the word of chiropractic wellness throughout Africa and regularly offers spinal screenings and health talks for the public. The second PEAK clinic is The Spinal Clinic, owned and operated by Dr. Brian Cox. Dr. Cox graduated from LIFE in 2002 and currently owns four clinics in Ghana. In addition to chiropractic care, his offices offer lifestyle coaching, massage therapy, vibration therapy, and rehabilitation.” therapy.

Figure 6

Dr. Bryan Cox

Dr. Joseph Afor and Dr. Addai Marfor also entered into the system with Dr. Bryan Cox. Dr. Joseph Afor, director of Chiropractic Healing Place41 Dome, Parakou Estate, is noted for saying42 “sitting down is a disease.” He also received his Doctor of Chiropractic degree from Life University in 2004, US.41

Figure 7

Dr. Joseph Afor.

Dr. Addai Marfor on the other hand has been working in the United States. Dr. Addai Marfo is a Commonwealth of Virginia Board Certified Chiropractor and a Graduate of Parker college of chiropractic. He has achieved mastery of the science, art, and technique of chiropractic. He continues to be active in Ghana and truly has a passion for treating his patients. Dr. Addai Marfo prides himself on staying on top of the latest and most advanced techniques for natural health care. Amerilife Chiropractic Center is based in Kumasi and Accra. He sets up the best chiropractic care affordable to the needy in society.43

Figure 8

Dr.Addai Marfo in his normal chiropractic practice. amerilifegh.org

Ayurveda and Traditional Chinese Medicine Activism

In the case of Ayurveda, Rev. Samuel Saso was regarded as the pioneer in Ghana in 1997. He worked in the same clinic as Dr. Albert Arthur. The Traditional Chinese movement was pioneered by Beijing Clinic.

Beijing Clinic, started operations in July 1995 by Doctor John Jiang Aijun,17 specializing in the treatment of stroke, heart diseases, and hepatitis. It is the premier Chinese clinic in Ghana that provides specialized medical treatment for patients using acupuncture, therapeutic massage, and acupressure. More importantly, it uses both traditional and scientific Chinese herbal medicines, which almost have no side effects. The clinic is well recognized by Traditional Medicine Practice Council in Ghana (TMPC) of which Dr. John Jiang Aijun is one of its special advisors. He is also the General Secretary of the Ghana Traditional Chinese Medical Association. Beijing Clinic is also called to serve as a special advisory body on the National Technical Committee of Ghana Standard Authority in 2015 for standard traditional medicine development.

Summary and Conclusion

Naturopathy and CAM in general have come a long way in the Ghanaian dispensation. Naturopathy in Ghana finds its roots as far back as the 1960- 1970s. The type of Naturopathy practiced then was traditional Naturopathy. Professional modern-day Naturopathic development started around 2016, with the promotion and advocacy for Modern Naturopathy led by Dr. Raphael Nyarkotey Obu.

Before the establishment of the Traditional Medicine Practice Council, the Ministry of Health, Ghana, started with the establishment of a Traditional and Alternative Medicine directorate to prepare the grounds for the Council. The Traditional Medicine Practice Council was officially set up after the successful implementation of the Traditional and Alternative Medicine Directorate

Most naturopaths in Ghana work as private entities in their private clinics or hospitals, as Naturopathy is yet to be streamlined in the formal health system. In addition to Naturopathy, there have been great strides in other CAM branches such as Homeopathy, Chiropractic, and Ayurveda. Efforts are still underway to ensure standardization and streamlining of the practice and educational requirements of naturopathic practitioners in Ghana.

Figure 9

Prof. Dr. Raphael Nyarkotey Obu, conferred Pioneer of Modern Naturopathy in Ghana by Indian Medical Association, JDN, Odisha Chapter.

Source of Funding

None.

Competing Interests

The authors declare that they have personal relationships with Nyarkotey University College of Holistic Medicine & Technology (NUCHMT).

Acknowledgements

We thank Dr. Albert Arthur who granted permission to access the archives and disclose his identity as the key informant for the interview.

Authors Contributions

RNO conceptualized the study and conducted the key informant interview. Both authors triangulated the interview responses with archival records. LAB critically reviewed and proofread the manuscript for publication.