THE VALUE AND CONSERVATION OF MEDICINAL PLANTS IN MOZAMBIQUE

• G. Albano
  Department of Forestry
  Eduardo Mondlane University
  C.P. 257
  MAPUTO 00100
  MOZAMBIQUE
  
  
  1. ABSTRACT
  Medicinal plants have been the source of remedies for healthcare for the majority of people in Mozambique. They are affordable, reliable and constitute people's heritage. The value of medicinal is currently recognised by the Government due to their contribution to healthcare in rural and urban areas. This recognition opens up opportunities for collaboration between traditional and modern medicines which will enhance better healthcare for the people. There is a great demand for medicinal plants. The increased demand for medicinal plants can drive to over-exploitation some species reducing the availability of some species which might hamper healthcare for the majority of people. All stakeholders have responsibilities to the future development and conservation of medicinal plants. Legislation, regulation of trade, processing and cultivation are some immediate activities if continued availability of this resources is to be maintained. Cultivation and sustainable utilisation of medicinal plants should be considered together with the involvement of local communities as partners enjoying mutually benefit-sharing opportunities.
  
  2. INTRODUCTION
  About 80% of the people in Mozambique consult traditional medicine or use natural products (including medicinal plants) to cure, treat, prevent various ailments. Medicinal plants are affordable, reliable and constitute a cultural heritage to rural and most urban people (Green et al., 1991; Cunningham, 1995). These factors contribute to the popularity and demand that medicinal plants deserve for healthcare.
  
  The use of medicinal plants and practice of traditional medicine were banned during the colonial period in most African countries (Cunningham, 1994). Even after independence, the Government of Mozambique did not officially recognise the use and practise of traditional medicine believing that they lacked a scientific basis. Despite this, medicinal plants have always been used and valued by local people. The value of medicinal plants for healthcare is currently, gaining increased recognition. The creation of the Department for Traditional Medicine Studies (GEMT) in the Ministry of Health and the Traditional Medicine Practitioners Association (AMETRAMO) highlight this recognition and augers well for an effective collaboration between modern and traditional medicine.
  
  There is a relationship between urbanisation process and demand for medicinal plants. Big towns tend to demand larger quantities of medicinal plants than the smaller ones. Greater demand for traditional medicines result in an increase in harvesting of medicinal plants from the wild, increasing, in some cases, the depletion and vulnerability of the rural resource base creating thereby problems for primary healthcare (Cunningham, 1995). The conservation status of the Mozambican biological diversity and medicinal plants germplasm, in particular, is not documented. The Research and development (R & D) actions have been constrained by years of civil war and limited financial and qualified human resources.
  
  The research on medicinal plants in Mozambique can be divided in three main stages. The first stage comprehended qualitative listings of the plant species used to cure various diseases (e.g. Jansen and Mendes, 1983a; 1983b; 1990; 1991; Maite, 1987); the quantitative stage involved the use of quantification methods to estimate the abundance of medicinal plants including market surveys (e.g. Fato, 1995; Dai, 1997); and the conservation stage which involves the identification of appropriate conservation strategies (Halafo,1996; Nuvunga, 1998).
  
  GEMT has published the first four volumes of medicinal plants of Mozambique, an 18 volume series. Recent advisory reports (Green et al., 1994; Cunningham, 1995) appeal for co-operation and co-ordinated efforts for R & D in order to reduce waste of financial resources and human efforts due to duplications. Appropriate recommendations to ethnobotanical and taxonomic research and the need for legislation and regulation to conserve the country natural asset were also emphasised in those reports. Awareness of conservation priorities and importance of sustainable use of resources involving local communities and the need for cultivation should be raised among the stakeholders.
  
  The information herein is based on literature review, market surveys and assessment of the potential availability and use of medicinal plants for self administration by rural women in rural areas of Matutuine, Boane and Goba in southern Mozambique and Mec�fi and Pemba districts in northern Mozambique. A total of 52 households were visited during the visits in 1997 and 1998. Twenty (20) village households were visited in southern Mozambique and thirty-two (32) in northern Mozambique. The women from these areas were asked to identify plants used for day-to-day family healthcare needs using semi-structured interviews (Martin, 1995). The present paper analyses the actual situation of medicinal plants use, trade and conservation in Mozambique as well as discusses the importance of the involvement of modern and traditional medicine in healthcare of rural people. In addition, it suggests options for future actions.
  
  3. SOCIO-ECONOMIC SITUATION AND RELATED PUBLIC HEALTH CONTEXT
  Mozambique has a population estimated at 16,5 million inhabitants with an annual growth rate of about 2,3% (INE, 1997). During the last 20 years, due to war, most of the people secured refuge in neighbouring countries or were displaced from their homes. With the onset of peace most people have returned to their former locations, they are resettling and struggling to meet their basic human needs. Most of these people lost their cultivated fields and livestock during the war and they have found natural products their means of survival. Slush and burn shifting agriculture, fishery, wildlife exploitation and charcoal production are the main economic activities.
  
  Agriculture accounts for 24.6% of the GDP, employ ca. 70% of the manpower and contribute about 80% to the foreign exchange earnings (cf. Lambert & Albano, 1997). Agriculture is the main activity with key food crops being cassava, maize, sorghum and beans.
  
  Forest cover accounts for 60 million hectares (cf. Lambert & Albano, 1997). Deforestation is accelerating with the returning of people to rural areas, clearing for agriculture, building materials, fuel wood, and other non-timber forest products. The use of the forest and their products for obtaining cash without observing resource sustainability is becoming a national concern. The need for the involvement of the local people in the management of the resources is seen to be crucial for sustainable utilization and protection of the ecosystems. The forest legislation states that communities be an obligatory partner in the development and sustainable management of the forest resources.
  
  Mozambique is one of the highly indebted countries in the World with the GDP of US$ 128,3 (1997) (INE, 1997). The national budget is not sufficient to cover all economic and social needs including healthcare expenditures. Most people procure medicinal plants as their immediate source of remedy to treat health problems. The main health problems are diarrhoea, acute respiratory infections, pneumonia, tuberculosis and malaria (Cf. Lambert and Albano, 1997). Malnutrition is also present in about 6% of children (Green et al., 1991).
  
  4. REFLECTION ON MEDICINAL PLANT ISSUES AND PERSPECTIVES
  The curative value of medicinal plants is not only owned by traditional medicine practitioners (TMPs). Rural people are knowledgeable about the curative effect of plant resources acquired through their day-to-day experience or information is acquired through oral communication. People can use medicinal plants based on their experience (self administration) or after medication by a TMP.
  
  Self administration using medicinal plants
  The use of medicinal plants in healthcare is a common practice in Mozambique. In rural areas medicinal plants for day-to-day healthcare needs are collected, prepared and utilised at essentially no cost to the family. Women often know the medicinal plants used to cure children's diarrhoea or epilepsy (Maco� pers. Com. 1998). Children tend to have about four to five episodes of diarrhoea during the childhood stage (Lambert & Albano, 1997). In southern Mozambique, the only available source of drugs were galenics. Surprisingly, only about 78% (25) of the Mec�fi and Pemba households revealed to use medicinal plants. Previous study believes that the use of medicinal plants in rural areas in Mozambique is almost 100% (Lambert and Albano, 1997). Even though there is high dependence of rural people to medicinal plants for healthcare the numbers should be handled with care.
  
  All people visited agreed that plants play an important role as the primary source of remedies. The main sources range from home yards, cultivated fields, early fallows to forests. The forest is the most preferred vegetation type by herbalists because of their high diversity in species and species life-forms (Cunningham, 1995). The value that forests have to the knowledge of herbalists can be associated to the need for conservation of this ecosystem and call for their collaboration.
  
  Traditional medicine, Modern medicine and Healthcare
  
  The numbers and distribution of TMPs is more adequate to serve the population. There are more than 80,000 TMPs and many more are not yet registered (Green et al., 1991). The TMP : population ratio is about 1 : 200 compared to the modern medical doctors : population ratio of 1: 35,000. It means that only about 20% of the people are covered by modern medicine. The co-existence of these two services for providing healthcare can be advantageous if collaboration is guaranteed. The lack of such collaboration can result in bad and poor distribution of healthcare services to the rural and most urban population.
  
  GEMT has been promoting workshops with the rural health centres/posts and AMETRAMO members to enhance collaboration between the modern and traditional medicines. Due to financial constraints only few locations were visited. In a recent research visit to some rural health posts in Maputo Province, the nurses were sensible to the importance of traditional medicine. For instance, if nurses diagnosed a patient with psychological disorders they would refer him to a TMP. On the other hand, the local TMPs are also aware about the need to send all patients that they are not sufficiently prepared to treat to the health centres/posts. Cases of patients brought to the hospital accompanied by their "inyanga" (herbalists) or "vanyamusoro" (diviners) have been reported from the Boane health post.
  
  In northern Mozambique (Mec�fi) where no workshops have been held yet there is no such collaboration and understanding between the two services. As a result, patients tend to report to health units too late to administer any treatment, consequently many people die of malaria and malnutrition (Albano, 1998). It might be because people tend to use medicinal plants at home and after the remedies have failed to work that they visit a village TMP, and as a last resort, go to the nearest health post. In Mec�fi and Pemba districts local people use Jateorhiza palmata (Lam.) Miers roots ("colombo", the source of radix colombo) to treat malaria. The effectiveness of this medicine lacks scientific prove. This situation demonstrates how valuable is co-operation between the two medicines and suggests the urgent need to continue with the GEMT efforts. The initiative of GEMT should be encouraged and adequately funded.
  
  Market trade of medicinal plants
  
  The market trade of medicinal plants in Mozambique is a practise in Cities such as Maputo and Beira. These areas are characterised by high population density, high unemployment rates and high cost of living. This reality creates possibilities for emergency of diseases and social uncertainties. Medicinal plants to cure for example, sexual transmitted diseases and aphrodisiacs to secure a job or a girlfriend will always be needed. In South Africa, for example, the trade of medicinal plants has turn-over of about $US 160 million per annun (Mander et al., 1996). In Mozambique, there is a progressive increase in the number of vendors and species sold in markets. In 1995 there were more than 65 people selling about 92 medicinal plant species in three markets in Maputo City (Fato, 1995). In January 1999 were counted 68 species sold in just one of the three markets above mentioned. The increase in the number of medicinal plants indicate the value of traditional medicine to the healthcare system.
  
  The trade in medicinal plants is a significant source of employment. The men selling medicinal plants in the markets of Maputo are aged between 10 to 30 years old compared to the women who are mostly 40 to 60 years old (Fato, 1995). Most of the young men are employees of TMPs or collectors. Their knowledge for the right dosage for every medicine might be limited. If AMETRAMO decided to implement market of plants in package form cleared by a recognised authority, would help to improve the reliability, safety and increase their value added.
  
  International trade of medicinal plants
  MEDIMOC, a estate enterprise, has exported as from 1982 to 1993 raw medicinal plant materials mainly to Europe worth US$ 100,000 (Atal, 1993). According to this author the species exported include Ricinus communis, Gloriosa superba, Harpagophytum procumbens, Tabernaemontana elegans, Jateorhiza palmata, Terminalia sericea. No detailed accounting or documentation of plant source and sustainability of supply for these material are provided by MEDIMOC.
  
  In 1995, J. palmata was not exported due to reduction of areas of collection. However, MEDIMOC was searching for new markets for a wider range of medicinal plant species because was expecting the increase of volume of medicinal plants for the following year. J. palmata is a herb occurring in coastal forests of Nampula and Cabo Delgado. The supply of this species to international markets through harvesting from the wild might have an adverse effect on the overall biodiversity of that coastal ecosystem.
  
  The supply of plant material to large multinational pharmaceutical companies is thought not to bring short or long term benefits to the local communities (Adamo et al., 1998). The low prices paid for excessive quantities of plant material accounts for the reduced revenues and it does not promote conservation of the resource. The on site price paid for a quilo (Kg) of J. palmata sliced and dried rhizome in Mec�fi in 1998 was equivalent to US$ 0.13. However, the export price from 1980 to 1993 had increased as from US$0.40 to US$ 0.80/Kg (Atal, 1993). The low prices practised on site tend to enhance the exploitation of large quantities of material driving certain habitat and/or resource to destruction. A more equitable pricing structure between costs on site and market outlets need to be introduced (Adamo et al., 1998). If these materials were locally processed and packed would gain value added reducing the need to explore large quantities.
  
  The involvement of middlemen in transactions of medicinal plants is another factor which contributes to reduction of the returns to the collector. In 1998, about 800 Kg of J. palmata material were left rotting in Mec�fi (Albano, 1998). This material had been requested by a middleman who had promised to buy and never turned up. A partnership between the interested enterprise and the local community should be considered in order to guarantee revenues to the local people, resource conservation, reduced waste and production of high quality material. The partnership between local and international counterparts with mutually acceptable benefit-sharing options have also appointed to be a regulatory mechanism to access to genetic resources (Adamo et al., 1998).
  
  Conservation
  
  Great demand for traditional medicine due to rapid urbanisation has resulted in an increase in harvesting of medicinal plants (Cunningham, 1995). The intensive harvesting of medicinal plants from the wild due to greater demand has driven a number of species to near or total extinction. Warburgia salutaris (Bertol. F. ) Chiov is one of the species extinct in the wild in South Africa and Swaziland (Cunningham, 1994). This species is now being exploited in southern Maputo province, the only area in Mozambique where the species occurs. TMPs in southern Maputo province recognise that Warburgia salutaris and Securidaca longipedunculata Fresen are becoming scarce and are willing to cultivate them. Some TMPs in Maputo are already cultivating species that are difficult to be found (Lambert & Albano, 1997). The scarcity of this species is also contributed by non sustainable harvesting. Cases of individuals of W. salutaris totally ring barked by collectors for commercial purposes have been reported from Matutuine area.
  
  Cultivation of medicinal plants is needed to conserve biodiversity and protect endangered species (Cunningham, 1994). Cultivation could well be performed if the conservation status of medicinal plants for Mozambique was documented. Despite of this, the Botanic Gardens at Eduardo Mondlane University (UEM) and at the National Herbarium (INIA) are involved in the cultivation (ex-situ conservation) of the most sought after plant species (including medicinal plants). The cultivation of medicinal plants for commercial purposes requires the correct identification of the practices which can give sustainable yields and quality products. Country experiences with indigenous species reveal that lack of sufficient information on the cultivation methodologies, the performance of most indigenous plants, autecology, costs and benefits might hamper cultivation.
  
  Efforts need to be made to promote cultivation of certain species. A project involving the Coastal Zone Management Project (PGCM) and the Department of Forestry (UEM) has started with identification of commercial valued species in Mec�fi district, Cabo Delgado Province. This initiative aims at assessing cultivation methodologies and exploring opportunities for dissemination of these methodologies to the local communities.
  
  The conservation of medicinal plant diversity can also be done through conception of protected areas and germplasm conservation. Habitats with vulnerable or endangered plant species could be conserved with the involvement of the local communities. Due to the high risk of losing valuable indigenous plant resources due to deforestation (Bandeira et al., 1994). The National Plant Genetic Resources Centre (NPGRC) has been created to collect, conserve, document and promote utilisation of the countries plant genetic resources. Germplasm collections in the country involve wild and cultivated genetic resources and they have about 158 species including medicinal plants.
  
  The recording of depletion extinction of plant species provides valuable information about the conservation status of the plant species. In Mozambique, there is no such recording as little plant collection has been done. An attempt of producing a red data list for Mozambique were done by Bandeira et al. (1994) using herbaria vouchers. Some threatened medicinal plants are listed in the table below.
  
  4. CONCLUSIONS
  
  1. Medicinal plants are the primary source of remedies for healthcare to most people in Mozambique.
  
  2. The collaboration of TMPs and modern medicine can contribute to the guarantee of good healthcare. There is a need for increased efforts to enhance such collaboration.
  
  3. The promotion of trade of packed medicinal products could help improve reliability and safety.
  4. Cultivation of medicinal plants, partial processing and partnership would guarantee revenues to the local communities and resource conservation.
  5. Local communities should be involved as partners in the international trade of medicinal plants.
  
  RECOMMENDATIONS (actions needed)
  
  1. Encourage collaborative activities between healers and modern medicine to improve public healthcare.
  2. Support a project on the production of partially processed medicines produced from herbal raw material medicines in Mozambique. This can be done by AMETRAMO or other non Governmental Organization (NGO) who would produce high quality packed materials, starting with the commonly known and used medicinal plants.
  3. Legitimise traditional knowledge practices and contributions to healthcare by promoting intellectual property rights.
  4. Funding for collaborative research between scientists and TMPs on key and relevant issues:
  * Culturally accepted remedies;
  * Frequently used plants by TMPs;
  * Dosage;
  * Identification of the rare and the most sought after medicinal plants; and their need for cultivation;
  * Identification of habitat sources; and
  * Cultivation methodologies for relevant medicinal plants.
  5. Encourage partnership between the interested enterprise and local communities so that local people can benefit from surrounding resources.
  6. Encourage promotion of existing institutions rather than create new ones and guarantee funding for their full operation.
  
  7. Promote export of cultivated medicinal plants.
  
  ACKNOWLEDGEMENTS
  
  I would like to express my gratitude to Dr. P. Matakala, Mr. S. Bandeira and Mr. A.J. Macucule for corrections to the manuscript and suggestions.
  
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