2. Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa MA Chauke, LJ Shai, MA Mogale, MP Mokgotho, SR Magano, P Tshisikhawe

3. Medicinal plants “It is believed that an apple a day keeps the doctor away and if you eat leeks in March and wild garlic in May, and all the year after the physicians may play.” Traditional American and Welsh rhymes. Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

4. Introduction  WHO 2004 definition medicinal plants  It is documented in literature that medicinal plants are, and have been used in all cultures as a source of medicine (Da Silva et al.1999)  WHO estimated the global market for traditional medicinal plants at $83bn a year in 2008 with sales growth between 5% and 18% in recent years  A great proportion of South Africa’s populace lives in rural areas  This is characterized by socio-economic problems  These problems make some medicines’ inaccessible to rural communities (Hifa 2015 campaign; 2010) Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

5. Introduction cont.  Use of plant based treatment has led to the belief that natural herbs are safe (Erasto 2003)  Our very own President, Mr Jacob Gedleyihlekisa Zuma in October 2011 has called for speedy standardization of traditional medicinal plants  Furthermore, a great proportion of modern pharmaceutical drugs have been modelled around plant-based compounds  Traditional medicine practices and associated knowledge therefore provides important leads in the discovery of these modern pharmaceuticals (Tamboura et al., 2000)  Ethnobotanical studies will continue to play a significant role in the discovery of new, cheaper and safer medicines (Patwardhan, 2005) Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

6. Introduction cont.  However, systems of African traditional medicines are poorly recorded and with the high rate of deforestation  Therefore information gathered in studies of this nature may justify intensifying conservation efforts in some African countries Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

7. Aims and objectives  The aim of the study was to conduct an ethnobotanical survey on medicinal plant material used by traditional healers and doctors of Mashishimale village in Phalaborwa, South Africa, for treatment of diabetes mellitus and other healthcare problems through the following objective: I. interviewing traditional healers in the area II.collect information on plants species they are using for the above diseases and III.identifying the plants.  The authors have no knowledge of any ethnobotanical studies conducted in this region of Limpopo province, South Africa. Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

8. Materials and Methods Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa Interviews  Structured questionnaire  Informed consent form  Participation was voluntary  24 traditional healers interviewed Interviews  Structured questionnaire  Informed consent form  Participation was voluntary  24 traditional healers interviewed Identification of plant species  Healers accompanied us  Plants mentioned were identified Identification of plant species  Healers accompanied us  Plants mentioned were identified Collection of plant material  The plant were collected in March 2012  Pressed in a herbarium press for two weeks  Kept at room temperature under dry conditions  Deposited into University of Pretoria’s herbarium for identification Collection of plant material  The plant were collected in March 2012  Pressed in a herbarium press for two weeks  Kept at room temperature under dry conditions  Deposited into University of Pretoria’s herbarium for identification

9. Interviews  Of the 24 traditional healers interviewed only 15 agreed to participate in the study  Healers that agreed to give information were all females  The age of the healers could not be established  But is between the ages 18 and 60  Collecting information from most healers was difficult  Many of the healers indicated that they learned all about medicinal plants from their parents and grandparents Click to add caption [10.5, italic] Results and discussion Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

10.  The part of the plant used for preparations of the infusions are the aerial and underground  Healers consulted prefer using roots (51%), while 30% use stem bark, and 19% leaves  Decoctions (boiling) is the most used method of preparation (74%) Figure 1 Figure 1 and 2: Part of plant used and mode of preparation Figure 2 Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

11.  A total of fourteen species was indicated  Aloe species and Mormodica balsamina (bitter melon-nkgaka in local language) being the main ingredients of the preparations.  Mormodica balsamina is also used as a vegetable (morogo) by the local people.  Other plants species that were listed were Cassia abbreviata, Opuntia ficus-indica, Tinospora fragosa and Grewia villosa Figure 3: Plants used for diabetes mellitus treatment Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

12.  This was one of the fields that seemed to be a speciality of healers around this area.  A total of about nineteen plants were mentioned for sexually transmitted diseases and seventeen for fertility and erectile dysfunction respectively.  Aloe species as well as Senna italica, Helinus intergrifolius, Ximenia caffra and Tinospora fragosa were the main ingredient for STI.. Figure 4: Plants used for sexually transmitted disease Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

13.  Tharaa, Tinospora fragosa and Helinus intergrifolius were mentioned for fertility and erectile dysfunction.  Treatment for both the STI’s and fertility are overlapping for most of the plants used.  It is likely the healers concentrate more on this problem as it is one that affects the local community with more teenage pregnancy.. Figure 5: Plants used for infertility and erectile dysfunction Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

14.  Fourteen plant species were indicated  Terminalia sericea, Cassia abbreviata, Grevillea buxofolia, Ozoroa paniculosa and Schotia brachypetala been mentioned more than once by the healers suggesting probable efficacy.  Of all the plants listed only Colophospermum mopane was indicated for stomach ache treatments in small children where the leaves are chewed and spitted into the patient’s mouth. Figure 6:Plants used for stomach ache and vomiting treatment Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

15.  There is a general believe amongst the interviewed healers that AIDS is not a viral disease  They also confirmed that they cannot cure AIDS  Three plant were listed, Cassia abbreviata, Ozoroa paniculosa and Terminalia sericea  The healers had very limited idea about cancer  Most of them believed is the work of witchcraft  The responded all seem to agree that tumour was “sefolane” which is a word used for any form of growth outside the body.  Two plants species come up on the conversation; Combretum imberbe and Dichrostachys cinerea Plants used for acquired immuno deficiency syndrome treatment (AIDS) and cancer Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

16.  Fabaceae family was the one mentioned most frequently (11 plants)  Followed by the combretaceae (6 plants),  Ebenaceae and Anacardiaceae (3 plants), Celestraceae (2 plants) and  The rest of the plants family were mentioned just once. Figure 9: Plants families Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

17.  This study provides information regarding knowledge of indigenous plant material that can be learned from traditional healers and elders while they still can.  The information can be recorded in the indigenous plant knowledge system for generations to come so that knowledge of culture and related information regarding medicinal plants is not lost with the older generation. Conclusion Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa ]

18. Further work still to be done is  in vitro enzyme inhibition bioassays  kinetic studies on active plant extracts  phytochemical analysis  antioxidants and cytotoxicity studies.  antimicrobial activity and anti-HIV-1 reverse transcriptase activity of plant material. Further work Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa

19.  This work is supported by funds from the National Research Foundation and the Tshwane University of Technology.  A special thanks to Dr Shai for his understanding and guidance throughout the project and his team of EL students.  Magda Nel from the University of Pretoria’s herbarium for helping with identification of plant material. Acknowlegdement Ethnobotanical survey of medicinal plant material used to treat and manage diabetes mellitus and other health-care problems in Phalaborwa, South Africa