# Ethnomedical Survey of the Plants Used by Traditional Healers in Narok County, Kenya

Authors: Gabriel Kigen; Zipporah Kamuren; Evangeline Njiru; Bernard Wanjohi; Wilson Kipkore
Journal: Evidence-Based Complementary and Alternative Medicine
 (2019)

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## Abstract

Most of the plants used by herbalists amongst the various Kenyan communities have not been documented despite their widespread use. The purpose of this research was to document the medicinal plants used by the herbalists from the Maasai, a community that still relies on herbal medicine to a large extent for the provision of medical services. Semistructured interviews, direct observations, group discussions, and in-depth interviews were used to collect information from the traditional healers. A total of 47 plant species belonging to 31 families were identified. They were used in the treatment of 33 medical and 4 veterinary conditions.


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## Body

## 1. Introduction

Medicinal plants still play an important role in primary healthcare in many sub-Saharan African countries due to variety of reasons including lack of health services, cultural norms, and traditional beliefs [1–3]. Many patients in these countries combine traditional medicine (TM) with conventional medicine, especially those with chronic diseases [4]. The use of TM is in most cases widespread and not only limited to the rural areas or low-income settings, but also in urban and well to do settings [3, 5, 6]. In addition, there is a growing global demand for traditional and complementary medicine [2]. The knowledge of these medicinal preparations is therefore important in order to enable health practitioners to be aware of the kind of TM their patients are on, so as to minimize potential adverse effects resulting from herb-drug interactions [7]. The documentation of the type of medicinal plants used by the traditional medical practitioners (TMPs) and the conditions treated is crucial to this endeavor [4]. In addition, databases containing this information would also be important for research and potential development of new drugs, as many of the drugs in current use have been developed from medicinal plants [8, 9]. Examples of these include paclitaxel, an antitumour drug developed from the bark ofT. brevifolia [10], the antimalarial drug artemisinin fromArtemisia annua [11], digoxin fromDigitalis lanata, atropine fromAtropa belladona,aspirin fromFilipendula ulmaria,and several other drugs. However, despite the widespread use of medicinal plants in Kenya, several have not been documented [4, 12]. The main aim of this research was to document the medicinal plants used by the Maasai community in Narok County, one of the regions in Kenya whereby the practice of herbal medicine is still widespread for future research.


## 2. Materials and Methods

### 2.1. Study Area

The study was conducted in two locations within Narok County, Olpusimoru (2°1′0′′S, 36°54′0′′E) a highland area located in the Northern part; and Sekenani (1°30′58.33′′S, 35°20′19.63′′E) a lowland area located in the South-Western region [Siana Ward] [Figure1]. Olpusimoru is a mountainous forested terrain with an average altitude of 2478 metres and high rainfall, while Sekenani has an average altitude of 1820 m with comparatively low rainfall. It borders the globally famous Maasai Mara National Reserve on the East [13, 14].Figure 1
Map of Narok County showing Olpusimoru and Siana wards and its position within Kenyan map.


### 2.2. Data Collection

Ethnobotanical data was collected from TMPs between March and December 2016. The research team is comprised of professionals from the medical field and botany, including a physician (EN), two clinical pharmacologists (GK and ZK), a taxonomist (BW), and a plant specialist (WK). There were also two local lead persons, one from each site who accompanied the team at each visit in order to direct and introduce them to the TMPs. All TMPs that we met were willing to participate in the research. A total of 37 TMPs comprising 20 men and 17 women aged between 42 and 85 were interviewed. Semistructured interviews, direct observations, group discussions, and in-depth interviews were used to collect ethnopharmacological information [15–17]. The participant’s biodata, conditions they treated, methods of treatment, medicinal plants used, methods of preparation and administration, and dosing forms were recorded. They were also asked to explain the manner in which they arrived at a diagnosis. At the end of each interview, the informants were requested to accompany the research team to sites where they collected the plants and assist in identification. Preliminary identification of the plants was then done by BW and WK, and the plants and their surrounding habitats photographed. The voucher specimens were then collected using standard botanical procedures, and further identification and confirmation were performed using the relevant taxonomic keys at University of Eldoret Herbarium where the specimens were subsequently deposited [18, 19]. The data was then compared to related research that has been carried out in the region.


### 2.3. Data Analysis

The medicinal importance of each plant species used was calculated as per the use-value index for each plant species(UVs) using the formula:(1)UVs=UNwhere U is the number of different uses mentioned by each TMP (informant) whereas N is the total number of TMPs interviewed during the survey [20, 21]. TheUV index theoretically varies from 0, which implies that none of the informants mention any use of the plant, to 1 whereby the plant is most frequently mentioned as useful in treatment of the highest number of conditions.


## 2.1. Study Area

The study was conducted in two locations within Narok County, Olpusimoru (2°1′0′′S, 36°54′0′′E) a highland area located in the Northern part; and Sekenani (1°30′58.33′′S, 35°20′19.63′′E) a lowland area located in the South-Western region [Siana Ward] [Figure1]. Olpusimoru is a mountainous forested terrain with an average altitude of 2478 metres and high rainfall, while Sekenani has an average altitude of 1820 m with comparatively low rainfall. It borders the globally famous Maasai Mara National Reserve on the East [13, 14].Figure 1
Map of Narok County showing Olpusimoru and Siana wards and its position within Kenyan map.


## 2.2. Data Collection

Ethnobotanical data was collected from TMPs between March and December 2016. The research team is comprised of professionals from the medical field and botany, including a physician (EN), two clinical pharmacologists (GK and ZK), a taxonomist (BW), and a plant specialist (WK). There were also two local lead persons, one from each site who accompanied the team at each visit in order to direct and introduce them to the TMPs. All TMPs that we met were willing to participate in the research. A total of 37 TMPs comprising 20 men and 17 women aged between 42 and 85 were interviewed. Semistructured interviews, direct observations, group discussions, and in-depth interviews were used to collect ethnopharmacological information [15–17]. The participant’s biodata, conditions they treated, methods of treatment, medicinal plants used, methods of preparation and administration, and dosing forms were recorded. They were also asked to explain the manner in which they arrived at a diagnosis. At the end of each interview, the informants were requested to accompany the research team to sites where they collected the plants and assist in identification. Preliminary identification of the plants was then done by BW and WK, and the plants and their surrounding habitats photographed. The voucher specimens were then collected using standard botanical procedures, and further identification and confirmation were performed using the relevant taxonomic keys at University of Eldoret Herbarium where the specimens were subsequently deposited [18, 19]. The data was then compared to related research that has been carried out in the region.


## 2.3. Data Analysis

The medicinal importance of each plant species used was calculated as per the use-value index for each plant species(UVs) using the formula:(1)UVs=UNwhere U is the number of different uses mentioned by each TMP (informant) whereas N is the total number of TMPs interviewed during the survey [20, 21]. TheUV index theoretically varies from 0, which implies that none of the informants mention any use of the plant, to 1 whereby the plant is most frequently mentioned as useful in treatment of the highest number of conditions.


## 3. Results and Discussion

A total of 47 plant species belonging to 31 families were identified, out of which 36 (77%) were from the lowland area (Sekenani), while 11 (23%) species were from the highlands (Olpusimoru) [Table1]. The plant details including the voucher numbers are outlined in Table 2.Table 1
Classification of medicinal plants.
Family Species No Members  1. FABACEAE 5 Albizia gummifera, Dichrostachys cinerea, Erythrina senegalensis, Senegalia senegal, Vachellia nilotica  2. SOLANACEAE 4 Physalis peruviana, Solanum arundo, Solanum incanum, Solanum mauense  3. AMARANTHACEAE 2 Achyranthes aspera, Aerva javanica  4. APOCYNACEAE 2 Acokanthera schimperi, Carissa edulis  5. BURSERACEAE 2 Commiphora africana, Ficus sycomorus  6. CELASTRACEAE 2 Elaeodendron buchananii, Mystroxylon aethiopicum  7. EUPHORBIACEAE 2 Clutia abyssinica, Croton dichogamous  8. MALVACEAE 2 Grewia bicolor, Sida cuneifolia  9. RHAMNACEAE 2 Rhamnus prinoides, Ziziphus mucronata  10. RUBIACEAE 2 Galium aparinoides, Pavetta subcana  11. RUTACEAE 2 Teclea nobilis, Toddalia asiatica  12. APIACEAE 1 Anthriscus sylvestris  13. ASPARAGACEAE 1 Asparagus africanus  14. ASTERACEAE 1 Acmella calirhiza  15. BIGNONIACEAE 1 Kigelia africana  16. BORAGINACEAE 1 Cordia monoica  17. CANELACEAE 1 Warburgia ugandensis  18. CAPPARIDACEAE 1 Boscia angustifolia  19. COLCHICACEAE 1 Gloriosa superba  20. COMMELINACEAE 1 Aneilema equinoctiale  21. CRASSULACEAE 1 Kalanchoe crenata  22. CUCURBITACEAE 1 Momordica friesiorum  23. EBENACEAE 1 Diospyros abyssinica  24. FLACOURTIACEAE 1 Dovyalis abyssinica  25. LABIATAE 1 Leonotis mollissima  26. OLEACEAE 1 Olea europaea subsp. cuspidata  27. PRIMULACEAE 1 MyrsineaAfricana  28. ROSACEAE 1 Prunus africana  29. SANTALACEAE 1 Osyris lanceolata  30. SAPINDACEAE 1 Pappea capensis  31. VITACEAE 1 Cissus fischeri  Total 47Table 2
Medicinal plant uses.
No Botanical Name Family Voucher No. Maa name Habitat Parts used Method of preparation Medicinal uses 1. Achyranthes asperaL. AMARANTHACEAE OLP/08/15/007 Olerubat Highland Roots Boiled Arthritis  2. Acmella calirhizaDel ASTERACEAE OLP/08/15/009 Ekum Highland Flowers Crushed and mixed with water Oral thrush in children  3. Acokanthera schimperi (A.DC.) Schweinf APOCYNACEAE MAU/08/15/027 Olmorijioi Lowland Roots Boiled Syphilis Bark Soaked in water Arrow poison  4. Aerva javanica (Burm.f.) Shult. AMARANTHACEAE MAU/08/15/032 Eleleshwa-ekop Lowland Flowers Ground into paste & mixed with water East Coast Fever in cattle  5. Albizia gummifera(J.F. Gmel.) C.A.Sm. FABACEAE MAU/08/15/018 Osupakupe Lowland Pods Crushed Stomachache Roots Pounded Skin disorders  6. Aneilema aequinoctiale P. Beauv COMMELINACEAE MAU/08/15/020 Enkaiteteyiai Lowland Leaves Soaked in water Malnutrition, colds Flowers Pressed to produce juice Ocular disorders  7. Anthriscus sylvestris (L.) Hoffm APIACEAE MAU/08/15/028 Oldule Lowland Seeds Mixed with honey and chewed Chesty colds  8. Asparagus africanus Lam ASPARAGACEAE MAU/08/15/006 Empereempapa Lowland Leaves, stem & roots Soaked in water Mental illness Leaves Soaked in water Wounds Roots Soaked in water Venereal diseases Chewed Cough & sore throat  9. Boscia angustifoliaHarvey CAPPARIDACEAE MAU/08/15/001 Oloireroi Lowland Leaves Pounded Cattle fever Bark Crushed & mixed with water Gynaecological disorders  10. Carissa edulisHarv APOCYNACEAE MAU/08/15/003 Olamuriaki Lowland Roots Boiled Lower abdominal pains in pregnancy, gonorrhea, chest pains, polio symptoms  11. Cissus fischeriGilg VITACEAE MAU/08/15/011 Osurkurtuti Lowland Leaves Soaked in water Respiratory disorders in cattle  12. Clutia abyssinicaJaub. & Spach. EUPHORBIACEAE OLP/08/15/011 Enkiparnyeny Highland Roots Boiled Appetizer  13. Commiphora africana(A. Rich.) Endl BURSERACEAE MAU/08/15/034 Osilalei Lowland Roots Boiled Swollen testicles, abdominal pains Bark Chewed Snake bite Fruits Boiled Typhoid  14. Cordia monoica Roxb BORAGINACEAE MAU/08/15/031 Oseki Lowland Leaves, bark Leaves- boiled, bark - pounded Leprosy Roots Boiled Mental illness Leaves Pounded Ocular disorders  15. Croton dichogamous Pax EUPHORBIACEAE MAU/08/15/008 Ollokirdangai Lowland Roots Boiled Polio-like symptoms, gonorrhea, chest pain  16. Dichrostachys cinerea Wight et Arn FABACEAE MAU/08/15/009 Emerrumori Lowland Leaves Pounded Local anaesthesia, ulcers, gonorrhea  17. Diospyros abyssinica Hiern EBENACEAE MAU/08/15/025 Olchartuyian Lowland Bark Pounded & soaked in water Malaria, ocular d/orders in livestock  18. Dovyalis abyssinica (A. Rich.) Warb FLACOURTIACEAE OLP/08/15/006 Olmorogi Highland Roots Boiled Gonorrhea Leaves Chewed Toothache  19. Elaeodendron buchananii(Loes) Loes. CELASTRACEAE MAU/08/15/004 Osoket Lowland Roots Dried and ground to powder Wounds, syphilis Roots Boiled or dried and ground to powder Respiratory d/orders Leaves Chewed Diarrhoea  20. Erythrina senegalensis DC. FABACEAE MAU/08/15/036 Ol-oboni Lowland Roots Boiled Polio-like symptoms, gonorrhea, chest pain  21. Ficus sycomorusL. BURSERACEAE MAU/08/15/024 Olngaboli Lowland Roots Boiled, chewed Abortifacient  22. Galium aparinoidesForssk RUBIACEAE MAU/08/15/026 Olngeriantus Lowland Whole plant Pounded & soaked in water or boiled Throat cancer in cattle  23. Gloriosa superbaL. COLCHICACEAE MAU/08/15/022 Sakutayei Lowland Roots Chewed or soaked in water Abortifacient  24. Grewia bicolor MALVACEAE MAU/08/15/014 Ositeti Lowland Roots Soaked in water Respiratory d/orders, snake bite  25. Kalanchoe crenata(Andrews) Haw CRASSULACEAE OLP/08/15/008 Ormasilig Highland Leaves Warmed Poultice  26. Kigelia africana (Lam.) Benth. BIGNONIACEAE MAU/08/15/021 Oldarpoi Lowland Fruits Brewed Measles in children Roots Boiled Abortifacient Bark Boiled Headache Leaves Boiled Malaria  27. Leonotis mollissima Guerke LABIATAE OLP/08/15/003 Olbibi Highland Leaves Soaked in water or boiled Antiseptic, skin rashes, blood purifier  28. Momordica friesiorum (Harms) C. Jeffrey CUCURBITACEAE OLP/08/15/001 Esumeito Highland Roots Pounded & mixed with water Induce vomiting  29. Myrsine AfricanaL. PRIMULACEAE OLP/08/15/004 Seketet Highland Seeds Ground Antihelminthic, heartburn  30. Mystroxylon aethiopicum(Thunb.) Loes. CELASTRACEAE MAU/08/15/035 Olodonganayioi Lowland Bark Boiled Colic pain, especially in children  31. Olea europaea subsp. cuspidata (Wall. ex G. Don) Cif. OLEACEAE MAU/08/15/023 Oloirien Lowland Bark Pounded and soaked in water Antihelminthic Leaves Boiled Liver disease Roots Boiled Polio-like symptoms, gonorrhea, chest pain  32. Osyris lanceolataHochst. & Steud. ex A. DC. SANTALACEAE MAU/08/15/016 Olosesiai Lowland Bark Boiled Abdominal pains in children Leaves Pounded Diarrhoea Roots Boiled Gonorrhea  33. Pappea capensis Eckl. & Zeyh SAPINDACEAE MAU/08/15/029 Olkisik-ongo Lowland Bark Boiled Abdominal disorders  34. Pavetta subcanaHiern. RUBIACEAE MAU/08/15/002 Olabai Lowland Roots Boiled Gonorrhea Whole plant Soaked in water Cough in calves, fleas  35. Physalis peruvianaL. SOLANACEAE OLP/08/15/010 Ormumai Highland Roots Squeezed/chewed Tonsillitis  36. Prunus africana (Hook.f.) Kalkman ROSACEAE MAU/08/15/012 Olkujuk Lowland Leaves Pounded & soaked in water Appetizer Bark Pounded & mixed with water Stomachache  37. Rhamnus prinoidesL’Hér. RHAMNACEAE OLP/08/15/002 Olkonyel Highland Roots Boiled Gonorrhea, arthritis Stem Pounded and mixed with water Preservative  38. Senegalia senegal (L.) Britton & P. Wilson FABACEAE MAU/08/15/010 Oitioibor Lowland Roots Boiled Purgative, constipation & gonorrhea Bark Boiled Diarrhoea & abdominal disorders  39. Sida cuneifoliaRoxb MALVACEAE MAU/08/15/005 Olonini Lowland Roots Chewed Sore throat Boiled Reduce foetal movements in pregnancy  40. Solanum arundo SOLANACEAE MAU/08/15/013 Esokawai Lowland Roots Chewed, pounded & soaked in water Fever  41. Solanum incanum L. SOLANACEAE MAU/08/15/015 Entulelei Lowland Roots Boiled Abdominal pains, fever Raw roots used Toothache Leaves Chewed and applied Snake bite Fruits Juice Chest pain, wounds & skin disorders, Respiratory disorders in sheep  42. Solanum mauense Bitter. SOLANACEAE MAU/08/15/007 Olesayiet Lowland Berries Cooked Pneumonia Roots Boiled Anthrax in both humans and animals  43. Teclea nobilis Del. RUTACEAE MAU/08/15/019 Olgilai Lowland Leaves, roots Boiled Pneumonia, arthritis  44. Toddalia asiatica(L.) Lam RUTACEAE MAU/08/15/030 Oleparmunyio Lowland Bark Boiled or soaked in water Respiratory disorders Roots Boiled Malaria  45. Vachellia nilotica (L.) P.J.H.Hurter & Mabb FABACEAE MAU/08/15/033 Olkiloriti Lowland Bark Pounded and mixed with water Stomachache, indigestion  46. Warburgia ugandensisSprague. CANELACEAE OLP/08/15/005 Osokonoi Highland Bark Pound and mixed with water Malaria, abdominal disorders Boiled, ground to powder Arthritis  47. Zizyphus mucronataWilld. RHAMNACEAE MAU/08/15/017 Oloilalei Lowland Roots Soaked in water Snake bite Bark Boiled Arthritis, stomachacheMedicinal Plant Uses. The plants were used in the treatment of 33 medical and 4 veterinary disorders. The detailed list of the plants and their respective medicinal uses are outlined in Table 2 and Supplementary Material section (available here). The most frequently used plant wasSolanum incanumwhich had seven medical uses (UV = 0.19) followed byOlea europaea subsp. cuspidatawhich had five applications (UV = 0.14).Asparagus africanus,Carissa edulis, Commiphora africana, Elaeodendron buchananii,andKigelia africana had four medicinal uses each (UV = 0.11).Most of the plants used by traditional healers in Kenya have not documented despite the imminent risk of disappearance of this plants due to several factors including deforestation and overexploitation [4]. In addition, the practice is usually a guarded family secret, and some of the siblings may not be willing to inherit the art due to changing lifestyles [22]. The lack of adequate regulation of the practice in Kenya has also led to infiltration by several quacks. However, the Maasai is one community in Kenya which still practices TM to a large extent owing to several reasons including lack of adequate health facilities and traditional values [23]. Some of the reported plants have been evaluatedin vitro and found to exhibit pharmacological activities related to the uses described by the TMPs [24]. These includeAerva javanica, Asparagus africanus, Carissa edulis, Sida cuneifolia, and Solanum incanumwhich have demonstrated to possess antibiotic/antifungal activities [25–28], whileGloriosa superba that is used as an abortifacient has oxytocic activity [29]. The plants used by the TMPs are largely similar to those used by their Kalenjin counterparts that we have reported before, although for different medicinal uses [3, 12, 30, 31]. Additionally, the methods of preparations are slightly different as the Maasai TMPs tend to use a lot of cold herbal infusions prepared by soaking the plant parts in water and hardly use the burnt leaves/barks as their counterparts


## 4. Conclusions

It is important to document traditional medicinal plants used by the various communities in Kenya in order to develop a database for future research. The risk of the rapid disappearance of the knowledge on traditional medicine calls for an urgent multidisciplinary approach towards conserving the information before it is lost forever. Some of these plants may contain undiscovered pharmacological properties which can serve as ingredients for the development of new drugs as has happened in Asia with the discovery of artemisinin. Additionally, medical personnel would also have an idea of the kind of herbal medicine that their patients may be taking and therefore minimize toxic effects through herb-drug interactions.



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