The Kwame Nkrumah University of Science and Technology (KNUST) in September 2001 commenced a Bachelor of Science degree in herbal medicine at the Faculty of Pharmacy and Pharmaceutical Sciences with the aim to train health professionals (Medical Herbalists) who will provide primary healthcare using scientifically validated herbal medicines.
Although this was the first of its kind in Africa then and still is, Medical Herbalists were already being trained in countries like New Zealand, United Kingdom (UK), etc for years, with arrangements made in terms of internships, induction ceremony, regulation, in relation to practice after training by institutions that run the programme. This hasn’t been the case with KNUST thus the question remains “What are the steps needed to be taken by a university/institution in ensuring that new health professionals meet set objectives before, during and after their training?”
History has it that the then Deans of the School of medical sciences (SMS) and Faculty of Pharmacy were both sent by the academic board to Germany and UK in 2001 to study what was been done there in terms of BSC Herbal medicine as some universities run the programme after the idea to introduce the programme was proposed by a lecturer in the Faculty of Pharmacy. When asked earlier in 2016 in an interview if the programme has had good influence on the society so far?, Professor Merlin Mensah, a senior lecturer at the Department of Herbal medicine KNUST and a major contributor to the introduction of the programme , according to the official mouthpiece of the Ghana Herbal Medical Students’ Association (GHEMSA) ,“ The Student Phytotherapist magazine (second edition)”, he responded
“Yes and no. Before we started the programme, contact was made with the Ministry of Health with the hope that herbal establishments will be created within the ministry for graduates but we heard a rumor 3rd year into the programme that they didn’t know our faith so we had to go back again to have formal meetings with stakeholders. They said there was nothing they could do about the situation after the meetings so it was only in 2011 that the ministry agreed to the establishments so a pilot establishment started throughout the regions establishing herbal medicine units in some government hospitals. Till date the ministry has not made any move to access these pilot centres and come out with findings with regards to the patronage at the herbal units. If these had been done, more herbal units would have now been built in state facilities to the benefit of the public”
The aforementioned response as covered by the students’ magazine suggests that KNUST indeed made attempts through the Ministry of health, to make provisions for Medical herbalists within the healthcare delivery system before the commencement of the programme in the university but failed. Does this mean KNUST gave up after its attempts proved futile? It should be however noted that the piloting of the services of Medical herbalists in selected government hospitals in Ghana was made possible through an advocacy by the Ghana Association of Medical Herbalists (GAMH) with the support of the Business Advocacy Challenge Fund (BUSAC) in September 2012.
The approach to which the attempts were made by KNUST is however unknown. The main approach should have been to call on the Traditional Medicine Directorate (TAMDI) under the Ministry of Health to help amend the already established Traditional Medicine Practice (TMP) Act 2000, which was in place prior to the commencement of BSC Herbal medicine. ACT 575 of the TMP ACT 2000 gives a legal backing for the establishment of a regulatory council known as the Traditional Medicine Practice Council (TMPC) later established in 2010. The council is tasked with regulating and licensing all practices including herbal medicine under the traditional medicine umbrella. The sections in the TMPC ACT 575 are categorized under four main headings; Establishment and Functions of the TMPC, Registration of Practitioners, Licensing of Practices, and Staff, Financial and Miscellaneous Provisions.
Governing body of the Council is a Board as outlined in sub-sections under Establishment and Functions of the TMPC,
The Board consists of
(1) (a) five nominees of the Association at least one of whom is a woman,
(b) Two persons nominated by the Minister one of whom is the Director of the
(c) Two representatives from the universities and research institutions one of
Who is a pharmacist with an interest in traditional medicine and the other
A person with an interest in the preservation of biodiversity,
(d) The Director of the Centre for Scientific Research into Plant Medicine,
(e) The chief executive of the Food and Drugs Board, and
(f) The Registrar appointed under section 29 who shall be the secretary to the Council.
(2) The members of the Board shall be appointed by the President in accordance with article 70 of the Constitution.
(3) The Board shall have a chairman who shall be elected by secret ballot by the members of the Board from the five members of the Association referred to under para-graph (a) of subsection (1).
The ‘Association’ as seen in paragraph (a) of subsection (1) refers to the Ghana Federation of Traditional Medicine Practitioners Associations (GHAFTRAM). The association/federation was formed in 1999 in response to government’s policy of a common representation for all indigenous practitioners in Ghana prior to the enactment of the TMP ACT in 2000. This places other association of any form of practice of Traditional medicine that emerges (whether professional or not) under GHAFTRAM.
This has since been the case with the Ghana Association of Medical Herbalists (GAMH). GAMH since its inception have had to work under GHAFTRAM, an unprofessional indigenous practitioners’ federation. This aspect needs to be amended to give representation to GAMH as a professional body/association on the council’s Board with a say in the practice of herbal medicine in Ghana and the training, licensing, and regulation of Medical herbalists.
While GAMH has also been partly blamed for not ‘pushing’ for amendment of the TMP ACT in the article titled “Herbal medicine Practice; The Shortcomings of the professional Association (part 1&2)”, KNUST cannot be overlooked as a contributor to the shortcoming/ ineffective practice by medical herbalists due to its failure to ensure that proper arrangements are made within the ministry of health before commencing the BSC Herbal Medicine programme. It appears there was a rush in the commencement of the programme which is supposed to be a professional one. Professional in the sense that the university is supposed to monitor keenly what happens before graduation, during internship, induction ceremony after professional qualifying exams, and the actual practice.
Some people might argue that the TMP ACT was passed in 2000 when there was no BSC Herbal Medicine or Medical Herbalists and so KNUST couldn’t have done anything. It is important to note that despite the availability of The Traditional Medicine Practice Act 2000, there wasn’t a single policy document on traditional medicine development and so the Ministry of Health (MOH) in 2005 developed a policy on the development of traditional medicine in consultation with stakeholders including the Faculty of Pharmacy of the Kwame Nkrumah University of Science and Technology (KNUST) as contained in the policy document;.
The single policy document named “Policy on Traditional Medicine Development” in Ghana was developed, four years after the introduction of the BSC Herbal Medicine programme. The question then is, if KNUST was invited to take part in the development of the single policy document in 2005, that factored in previous policies by government, to give direction to the coordination of activities in the area of traditional medicine (which herbal medicine practice forms part), why wasn’t provisions made for Medical Herbalists as professionals?. Para-graph (c) of subsection (1) as outlined in sub-sections under Establishment and Functions of the TMPC also needs to be amended now that there are Medical Herbalists who now work in Universities as lecturers/researchers after post graduate studies. The absence of Medical herbalists on the TMPC board affects the quality of decisions taken by the board in relation to education curricula, and regulation of Medical herbalists.
The registrar of TMPC, Torgbui Yaka IV in a meeting organized on Monday 29th August, 2016 at the conference room of the Osu Presby hall to sensitize graduates on expectations of internship stated that no law exists to direct the council on what to do with BSC Herbal Medicine graduates in terms of internship placements and requirements although the council has over the years tried its best monitoring internships. He further express his displeasure at the University (KNUST) and GAMH’s inability to request for amendment of the legislation that gives authority to GHAFTRAM with 5 members on the TMPC board.
Graduates are to embark on 2 years internship of which the first year is a national service at health institutions that provide herbal medicine services and the 2nd year at the Centre for Plant Medicine Research (CPMR) and Tetteh Quashie Memorial Hospital (TQMH) both at Mampong-Akuapem. It is not clear how the 2 years internship came into being and who instituted it as requirements before writing the professional qualifying exams (PQE) because it seems like a waste of time.
The internship should be reduced to 1 year just as other health professions. The reason being that the first year which is now on the National Service Scheme (NSS) is not properly planned in terms of what students are supposed to be taught at the places they are posted. Whiles some are placed in health facilities with herbal units, and herbal clinics/hospitals, others are sent to Food and Drugs Authority (FDA), and KNUST as teaching assistants. How then do those placed at non-health institutions sharpen their clinical skills especially in the practice of herbal medicine as required in the first year of internship?.
It’s only the second year that is well structured. Even with this, interns are not given allowances and thus have to rely again either on their parents or the little savings from NSS for accommodation and upkeep. Reducing the internship period to a year will now mean that graduates will proceed to TQMH and CPMR and receive monthly allowances through the national service scheme. Moreover herbal institutions who wish to employ graduates they worked with during industrial training will not have to wait after 2 years of internship to do so.
There is inadequate information about the programme on KNUST’s website. For instance, Information on the course modules is not available, just a summary of the programme. There have always been loop holes with clinical training and industrial attachment for herbal medical students in the university. Clinical training practical which used to be at the university hospital have now been moved to the Kumasi South Hospital, with no means of transportation offered to students. Students on industrial training are not monitored by KNUST through visits to ensure that they are getting the right exposures.
The industrial trainings are not well planned for a typical health profession and as such students are sometimes mistaken for pharmacy attendants/dispensers throughout the training period, in some health facilities with herbal units whiles others are thought to be nurses, medical laboratory scientists, etc. Delays in securing special national service postings for graduates in their first year internship by the herbal medicine department, KNUST recently seems to be the order of the day. The TMPC have had to fight to secure the special posting slots through the national service secretariat after general postings have been released all because KNUST fails to submit the special posting list on time.
This was the case in 2015 and now in 2016. Moreover it seems KNUST only monitors induction ceremonies of other health professionals that it trains aside Medical Herbalists (Herbal Doctors). Induction ceremonies have not been organized for different batches of qualified Medical Herbalists lately. The shortcoming of the university in paying full attention to the herbal medicine programme has affected and continues to affect the behavior of students, interns and resulting medical herbalists. The herbal industry is counting on the efforts of KNUST, GAMH, and other stakeholders to ensure that Medical herbalists have the controlling power of practice of herbal medicine to serve public interest.