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More Lagosians consume herbal mixtures, concoctions


Herbal<br />Mixtures, Concoctions

Take a stroll along any Lagos street and you are sure to find at least one or two herbal concoction sellers, either hawking or situated somewhere in the vicinity.

Popularly called ‘agbo’, this herbal brew has drawn quite a significant attention from the nation’s health sector, with lots of debates trailing it.

Presently, the use of traditional herbal medicine has become more pronounced, what with people being urged to return to nature in their diet and all else.

So, it appears some people don’t need any more prompting to totally embrace the idea of using herbal concoction for any ailment, despite the fact that controversies still trail its efficacy and safety in some quarters.

In recent times, however, this trend has taken on another dimension in the country, as consumption of the locally brewed gin mixed with some roots and herbs has reached an all-time high.

While some people are quick to attribute this trend to poverty level in the country, which has financially incapacitated many citizens, others feel it is a result of lack of adequate provision of medical care. So, people are forced to seek alternative methods of healthcare whenever they fall ill.

An article in a World Health Organisation (WHO) bulletin titled: “Herbal medicine research and global health: an ethical analysis” by Jon C Tilburt and Ted J Kaptchuk stated that traditional herbal medicines are naturally occurring plant-derived substances with minimal or no industrial processing that have been used to treat illnesses within local or regional healing practices.”

The above is evidence that WHO recognises the efficacy of herbal-based medicines, but only when appropriately prepared, under the right circumstance and with required standard.

Hitherto, the assumption was that the consumption of agbo was solely confined to illiterates, rural dwellers and the indigent in the society.

However, for whatever reason and with the recent indiscriminate sales of this intoxicating drink, it is attracting more subscribers from other classes in the society. And despite fears that the consumption of agbo could be detrimental to health, the number of people patronising it keeps soaring.

Interestingly, most of the respondents who spoke with The Guardian explained that they prefer using the alcohol-based herbal mixture to that of water-based, as they believe it is much more effective and lasts longer in the system.

A customer, who requested for an extra sachet of dry gin after taking the agbo, said it was the best form of treatment, and better than visiting the hospital repeatedly.

Another respondent, who bought N50 worth of what he called agbo sugar and jedi (pile), also said it is good because it is very bitter, as it naturalises all the sugar in the body.

Explaining that he likes taking soft drinks a lot, he said in Pidgin English: “This is the best typhoid treatment (pointing to a particular herbal drink in a bottle with creamlike content). The agbo works faster and effectively.”

Most lovers of herbal concoction said they couldn’t go a day without its consumption.

Iya Sule, an agbo seller around Isolo in Lagos, attested to this fact, as she explained that most people prefer buying the alcohol-based mixtures than that of water-based, though she sometimes mixes the two on request.

“The price and quantity differs because of the cost of Dry gin used as solvent. Alcohol extracts herbal roots much quicker than water. Alcohol only takes hours to extract, while water takes at least two days,” she explained.

During our conversation, several customers requested for the ‘pepper soup concoction,’ which was the most popular, and sold faster. This, she explained, is a mixture of the typical pepper soup spices of grape fruit, ginger, garlic and lemon grass, all cooked together.

“It is a treatment mixture for malaria, typhoid, piles, pains and general body cleansing. It is also used to detoxify,” she said.

The average price of two to three herbs and roots mixed together is N50, depending on whether it was alcohol or water-based. Many clients went for this category.

Another seller at Ladipo Market in Oshodi, where many of these herbal mixture sellers were located at relatively close distances, also explained that she regularly serves her customers what she called ‘signature combination’ on daily basis.

She said: “It’s much more efficacious than orthodox medicines, especially for my customers around here, as their daily activities require physical fitness.”

Asked about the method of preparation, she explained that most of the mixtures are always kept and extracted in plastic bottles, while the concoctions are cooked.

But how do they know the exact dosage to serve customers, since there was no sign of standard of measurement?

“We usually use a small cup to measure for cost sake. This ordinarily is not always too much to take, as it is good that the ailment meet the drug in the system, and not vice versa,” she said in Yoruba.

And truly, other roadside agbo sellers were observed using the ubiquitous small cups and bigger cups to serve customers with corresponding prices.

The notion at the back of an average agbo consumer’s mind is to keep healthy in the most natural way without any negative side effect from chemical reactions.

This, however, is a myth as studies have shown that excessive intake of alcohol, which is used, as a solvent for most of these mixtures, has no nutritional benefit. Rather, it damages such vital human organs as the kidney, liver, heart and pancreas, among others.

Chronic kidney disease (CKD) has become a major public health problem in Nigeria, and studies have established a clear relationship between alcohol intake and CKD.

Nigeria has one of the largest burdens of kidney disease in the world, with the prevalence of about 34 million people and an estimated number of 100 per 1,000,000 said to have the ailment. More worrisome is the alarming rate of kidney failure in the country, which stands at about 17,000 new cases every year.

As most agbo mixtures are alcohol-based, and those patronising it tend to consume daily, could this by any chance be part of the reason behind more Nigerians coming down with CKD?

Attesting to this fact, consultant nephrologist at the Healing Stripes Hospital, Lagos, Dr. Adedamola Akinsiku, explained that the huge burden associated with consumption of herbal concoction is not just limited to renal infections, but also affects every part of the body, as it is a major cause of liver problem, as well as predisposes consumers to hypertension and stroke, among others.

He said: “Herbal concoction has been shown to cause kidney diseases through many forms like chronic and acute tubulointerstitial nephritis (swelling in between the kidney tubules). It has been shown to cause acute kidney injury, hypertension, capillary nephrons and also exposes consumers to uroepithelial tumors (cancers of the genital urinary trucks.)

“The chemical agents inside these concoctions have not been isolated and evaluated. So, it is impossible for one to know the agent contained in them, their chemical reactions, what it works for, the extent it would work and the side effects. So, there are key issues there that are missing. We don’t know the dose as well.”

He, however, said consumers need to know that the efficacy of herbs are not out rightly overruled, just that there are adulterated forms and are not regulated, which is the major challenge.

Explaining the various ways herbal concoctions can affect the kidney, Akinsiku said: “It could be the straight toxic effect of the chemical in the mixture, which can directly cause harm to the kidneys. There is also drug reaction.

“Every medication is a chemical. The difference between an herbal concoction and orthodox medicine is that we already know the composition and side effects of various approved medications. But the composition for an herbal mixture is unknown. It is a bit more complicated than people can see.”

Akinsiku disclosed that 11 per cent of adults residing in Lagos state have chronic kidney diseases (CKD) and 29.2 per cent has hypertension, which relates to one in every three adults in Lagos.

He said this revelation was from a study titled: ‘The prevalence of chronic kidney diseases in adults residing in Lagos State,’ which he conducted in 2015.

“The studies discovered that diabetes, which was the leading cause of kidney diseases, was rather at a low side of 3.2 per cent, which means hypertension is rather the leading cause in Nigeria.

“We discovered that more than 80 per cent of adults in Lagos State take herbal concoction in one way or another to show how common it is. A bulk of artisans and traders majorly use these herbal purported multifunctional concoctions.”

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