Indigenous knowledge of folk medicines among tribal minorities in Khyber Pakhtunkhwa, northwestern Pakistan

Abstract

Ethnopharmacological relevance

Mapping ethnomedicinal plants and associated indigenous knowledge of folk medicines can provide a comprehensive overview of individual herbs employed in health care. Reliance on medicinal plants in remote parts of northern Pakistan is high, especially among women, but no research has investigated specifically which plants are used. This study investigated indigenous knowledge of folk medicines among tribal minorities in selected sites in upper Swat, Buner and Chitral Districts in Khyber Pakhtunkhwa Province.

Materials and methods

Interviews were conducted with gender-specific focus groups using questionnaires and standardized data sheets, followed by forest walks in each of the visited areas. General medicinal herb use, preparations, storage, marketing and collection habits for each gender group were ascertained from the questionnaires.

Results

In total 168 women and 390 men were interviewed and provided information on 127 different shared medicinal species. Species use consensus among the informants ranged from 2.3% to 83.3%, with Cynodon dactylon, Avena sativa, Celtis australis, Datura stramonium, Solanum nigrum, Skimmia laureola, Spiraea nervosa, Ziziphus jujuba, Rumex hastatus, Plantago lanceolata, Lathyrus aphaca and Ficus palmata having the highest reported consensus. The survey also revealed that a number of medicinal species were exploited by the community for both marketing and personal use, and many of these species were reported as being rare, vulnerable or even endangered.

Conclusions

The results revealed that women in all the three districts were important custodians of medicinal plant knowledge, but elder women in general and the women from Buner district in particular had a superior understanding of folk medicine. The forest walks revealed that women׳s traditional medicinal knowledge was based on a more limited diversity of plant species. People in tribal communities have an expressed interest in learning efficient techniques for medicinal plant collection, preparation, storage and cultivation advice, and to learn more about the potential of marketing medicinal herbs and ways to reach local market centers. Education and awareness were considered to be essential for improved health care and successful marketing.

Introduction

Medicinal plant gathering and processing for the preparation of herbal medicines is a centuries old practice amongst local communitiesin Pakistan for both men and women. The northern part of Khyber Pakhtunkhwa Province is particularly rich in floristic biodiversity, and commercial extraction of medicinal plants began here some 50 years ago, and continues to this day (Ahmad et al., 2014, Hamayun et al., 2006b, Hamayun et al., 2003b, Sher and Al-Yemeni, 2011, Shinwari, 2010). A lack of clear custodianship, little understanding of sustainable management practices and knowledge of market requirements, coupled with poor social status and economic opportunities for gatherers and inadequate institutional structures, place natural habitats and populations of medicinal plants at risk. Currently there is little evidence for the conservation of indigenous medicinal herb species within the area. Biotic pressure from population growth and resulting domestic activities are placing some species under threat (Lange, 2002, Olsen and Larsen, 2003, Sher et al., 2010).

Gathering and processing of medicinal plants is largely a family occupation for low income groups. In particular, women play an important role in the gathering and processing of medicinal plants for use within the immediate family and local communities (Pfeiffer and Butz, 2005). At the same time, reliance on medicinal plants in remote northern Pakistan is high, especially among women, but no research has investigated specifically which plants are used. In many areas it has been noted that the role that medicinal plants play in the economy and health care of isolated rural communities is still poorly understood (Bhattarai et al., 2006). Other research has identified medical herb gathering and processing by rural women and their immediate family members, as a possible source of human and livestock health maintenance, and also as a source of cash income (Barirega, 2014, Sher, 2013).

Herbal medicines, which include herbs, herbal preparations and herbal products, are the most widespread of traditional medicines (World Health Organization, 2008), and women their most frequent users (Hall et al., 2011, Murphy et al., 1999). Herbal medicines are used by women to treat a number of reproductive health problems, such as menstrual problems, infertility, discomforts and dysfunctions of pregnancy, labor and menopause (Beal, 1998). Research on the use of plants often focuses on male traditional healers, thus overlooking a wealth of knowledge that is held by women (Pfeiffer and Butz, 2005). Erosion and deterioration of traditional medical knowledge can be observed in many cultures and lead not only to a loss in biocultural diversity, but also diversity in alternatives for primary healthcare and lead for drug discovery (Farnsworth et al., 1985). Documenting the use of plants by ethnic minorities and tribal people is not only an important part in understanding and analyzing elements of traditional knowledge, but also a way to perpetuate knowledge at risk of being lost (de Boer and Cotingting, 2014).

The aim of this survey among communities in areas of known medicinal plant occurrence was to make a quantitative study of ethnomedical knowledge. Moreover, the aim was to provide an insight into the unmonitored aspects of medicinal plants harvesting and their socio-economic influence. An applied approach focuses on finding ways of making herbal medicine more beneficial and effective for personal use at a community level, and profitable on a domestic and international scale. This study was initiated with the aim to shed light on what has been perceived as a window of opportunity to address the socio-economic situation of women gatherers, and the conservation of naturally occurring medicinal plants.