The sale of roadside herbal mixtures in Abuja, Nigeria, is on the rise, a commerce that is driven by those who believe in its efficacy. Others buy tinctures because they believe they have no choice as they have no access to doctors or hospitals for financial reasons or because of the medical strike across many parts of the country.
The uptick has forced Nigerian authorities to approve and release guidelines for registration and control of herbal medicinal products and related substances under the auspices of the National Agency for Food and Drug Administration and Control (Nafdac).
However, even Nafdac approval and registration is not a mark of quality, said Abubakar Jimoh, spokesperson for the agency.
"At Nafdac, we give the herbal medicines a listing status, which means they are not fully registered as we can only vouch for the safety and not efficacy of these herbal preparations," he said.
And not every herbal medicine is registered, either, Jimoh told Africa Calling.
“Before Nafdac can give a full registration of any herbal medicine, it must go through the rigour of clinical trials. Most of these herbal doctors do not have the necessary wherewithal to go through the whole process of getting the product fully registered,” he added.
He notes that exposing medicines to different weather conditions reduces its potency and can make it harmful to consumers.
Outdoor herbal concoctions
At Sussie Herbal Healthcare Services roadside stand in Nyanya, a suburb of Abuja, Susan Igbudu, 30, hawks her cures.
Composed of various shapes and sizes of mostly packaged plastic bottles containing herbal mixtures, she says her products promote 'wellness'.
"These herbal medicines serve as preventive measures; take them to cleanse your body system and balance your hormones; they even boost your immune system," said Igbudu, while encouraging passers-by to try her products.
Igbudu says she studied agriculture at school and believed the best way to practice her course was to join the league of outdoor herbal medicine sellers in Nigeria, where she has been in business for seven years.
She eschews doctor-proscribed medication, believing the all-natural way is better.
"English medicine (orthodox) cannot be compared with traditional (herbal) medicine, as the latter is more potent," she said. "The reason why most of our herbal medicine does many things in the body is because of the combination of the herbs.”
One of Igbudu’s customers, Toffa Rati, agrees with her, and has seen a positive effect.
"I don't think taking herbal medicines is a bad idea. It works for me when I take them; it cures whatever they say it cures,” said Rati.
“But I take only herbal medicines that are NAFDAC approved. I try to avoid fake ones.”
Meanwhile, some Nigerians are sceptical and say they prefer orthodox medicines.
Tony Ochela who lives in Abuja says it is better to go to the hospital or a pharmacy where he can always lodge complaints if their medications do not work as stated.
"I have reservations about [buying] roadside herbal mixture that they tell you cures 10 illnesses. What if you have complications from that drug, since it is roadside, who will you hold responsible?" Ochela said.
These herbal medicines are not just sold at road stands like that of Igbudu's, they are also sold in shuttle buses, where advertisements blare out from loudspeakers.
One runs as follows: "Brothers and sisters, good evening, I am Nnamdi Felix, a qualified herbal medicine practitioner, do you have stomach problems, sexually transmitted infections etc, I have the best medicines for you."
Passengers have been observed by this correspondent, asking: "How much is it? How should I take it?"
For others that do not sell in these buses, they hang their loudspeakers on parked or slowly moving vehicles in crowded areas.
While people go about their daily activities, other slogans such as: "Don't bother going to the hospital, come to us for treatment" attempt to attract more people to buy from them.
The hawkers ads are efficient, said Adanna Uche-Okonkwo, a pharmacist with a government-owned hospital in Abuja.
"Despite being a health professional, sometimes when I am in these buses or around places where there is an advertisement for herbal medicines, I am tempted to buy because of how convincing the marketers sound,” said Uche-Okonkwo.
But good advertising does not mean good products, says the pharmacist.
“They even tell you that these medicines don't have side effects because they are from plants but that is very wrong. People who use them mostly do that out of ignorance,” added Uche-Okonkwo.
The only choice?
Nigeria's healthcare system is in a shambles. While hospitals grapple with the challenge of medical brain drain, the few doctors remaining in government hospitals have downed their tools three times this year alone.
Doctors complain that their welfare is not being taken care of.
"It is not a thing of joy for us to go on strike but we are pushed to the wall," said Dr Dotun Osikoya.
"How will you expect a doctor that is owed salaries of five or even eight months to have a sound mind to treat their patients?"
By and large, patients are then left with no choice but to go to private hospitals or pharmacies if they can afford it.
If not, the only alternative is to run back into the hands of herbal medicine sellers like Igbudu for treatment of their ailments.