MEDICINAL PLANT USE OF

Background: An ethno-medical survey of plants was conducted at Mashishimale village near Phalaborwa, in Limpopo Province (South Africa). Owing to high level of poverty and lack of proper daily operational healthcare facilities in certain parts of Mashishimale village, the use of plants as medicine persists. The aim of the study was to compile a list of medicinal plants used by traditional health practitioners for treatment of diabetes mellitus and other ailments. Materials and methods: Traditional health practitioners were identified using the snowballing sampling technique. Structured interviews were conducted and a list of medicinal plants compiled. Data collection included local names of the plants, the plant parts used in the traditional medicine, the disease treated by the plant-based remedies and the method of preparation of the medicines. Results and discussion: A total of 49 plants species belonging to 20 different families we identified. Plant parts used in preparation of remedies by practitioners are roots (51%), stem barks (30%) and leaves (19%). The most preferred methods of administration were boiling (74%) and infusion (12%). About 14 plants species were indicated for treatment of diabetes mellitus, while most plant species were indicated for sexually transmitted diseases, fertility and erectile dysfunction. Conclusion: The results of the survey indicate that plants play a significant role in primary healthcare of the community of Mashishimale Village. It would seem that a number of major diseases/ailments are treated by traditional methods. Scientific investigation is therefore needed to isolate active compounds and to determine safe dosages for treatment. These studies may guide the regulation of herbal medicine industry in South Africa.


Introduction
Reviews of literature involving research of medicinal plants suggest that scientists follow more or less the same general strategy to investigate plant materials for their healing properties (Jones et al., 2006;Kinghorn & Balandrin, 1993;Heinrich, 2003).This general strategy includes bioprospecting and selection of plant material; collection and identification of plant material; extraction of the plant material; screening the extract for healing potential; isolation of active compounds; characterisation and structure elucidation of isolated compounds and preclinical evaluation of the active ingredients or crude extract.
Plant selection for phytotherapeutic studies can be based on specific traditional use of certain medicinal plants (Harborne, 1998) or the chemotaxanomical data (Heinrich, 2003) or a combination of the two approaches.Another approach is use of literature database.The aim of this section of the study was to investigate and identify plant species used in preparation of medicinal remedies by traditional healers of Mashishimale Village in Phalaborwa, Limpopo.
Studies of ethnomedical uses of plants are important contributors to the discovery of new pharmaceutical drugs (Patwardhan, 2005).Despite the fact that 25% of modern drugs are phytochemical in nature or modelled around phytochemicals (Sofowora, 1996;Harvey, 2008), many areas have not been reached for inventory of medicinal plants.Some of these areas may be harbouring important sources of medicines for future generations.The area (Mashishimale village in the Mopani District, Limpopo) under study is no exception, as the authors have not encountered any report on medicinal plant uses by its inhabitants.However, ethnomedical studies were conducted in certain parts of the Limpopo Province (Semenya et al., 2012;Semenya and Maroyi, 2012).These studies focused on the Waterberg, Capricorn and Sekhukhune districts of the Limpopo Province.These districts differ from the Mopani District on the cultural groups inhabiting the respective district, vegetation and climates.
The study focused on medicinal plant species used by traditional healers of Mashishimale village near Phalaborwa (Limpopo province, South Africa).The village is situated about ±15 km west/south-west of the town of Phalaborwa (Fig. 1).The village is composed of several smaller sections (sub places), with a total estimated population of 13920 in a 13.35 km 2 (Census, 2011).The dominant cultures of the village Pedi (86%) and Shangaan (Tsonga) (8%).The ethnobotanical and ethnomedical uses of plants by native cultures of this area have received little scientific research interest.The participants were mostly Pedi speaking, and they were selected from the Tshubje section of the village, using a snowballing method.
Phalaborwa has one the highest winter temperatures (9 -25 o C) in South Africa, with low average rainfall.Summer temperatures range between 20 and 33 o C, and may occasionally rise over 40 o C (Bing Weather", accessed 6 June 2014).The study was approved by the Tshwane University of Technology's Research Ethics Committee REC2012/01/003/ChaukeMA).

Interviews
Traditional healers were identified using the snowballing sampling technique.Structured interviews were conducted with traditional healers in order to compile a list of medicinal plants used to treat diabetes mellitus and other diseases.Participation in the interviews was voluntary and respondents verbally consented to participate in the study.Interviews were conducted in two local languages, viz.Xitsonga and Sepedi.Data collection included local names of the plants, the parts of the plant used, medicinal uses of the plants and the method of herbal preparation.Frequency, in the context of this study, was an illustration of the number of times each plant was mentioned as an ingredient in traditional preparations to treat a specific disease.

Plant collection and storage
Plant materials were collected during March 2012 and March 2013.Plant species were grouped on the basis of the disease treated.Herbarium samples were pressed in a herbarium press for two weeks and voucher specimens deposited at H.G.W.J. Schweickerdt Herbarium at the University of Pretoria for identification.Each deposited herbarium specimen was given a unique identification number.The International Plant Names Index (IPNI) was used to verify all the scientific names and families.

Results and Discussion
Data was collected from traditional healers (dingaka-tshupswa) and traditional doctors (dingaka).In the context of this report, traditional healers have learnt of the uses of medicinal plants from friends and family, through knowledge passed down orally.Some of them have worked with traditional healers and doctors.Traditional doctors, on the other hand, have been formally trained by another traditional doctor, leading to their graduation as doctors (mathwasana).They combine spirituality with the practice of herbal medicine.Twenty four healers were interviewed, seven of whom were traditional doctors and seventeen healers.Of the twenty four interviewed only fifteen agreed to give the information while the rest refused.Collecting information from most healers was difficult as some of them expected payment while others thought giving information may lead to loss of income, competition in their trade and disrespect to the traditional beliefs and their ancestors.It is claimed that disseminating information about the healing powers of a plant remedy to investigators and even the patients may result in the medicine losing its power.Many of the healers indicated their knowledge of the medicinal uses of plants and the preparation of traditional concoctions was passed down from their parents and grandparents.The interviews also established that the parts of the plant used for preparations of the infusions are the aerial (leaves, stems, stem bark) and underground (roots).Figure 2 is an example of a traditional medicine preparation for treating infertility in women.The medicinal plants are used mostly as mixtures.About 51% of the medicines prepared for treatment of a variety of diseases are derived from roots of plants (Fig. 3).Leaves are the least preferred sources of medicines in this community.

Plants used for diabetes mellitus treatment
Many of the healers had an understanding of diabetes mellitus and indicated plant species used for treatment of the disease.A total of fourteen species were mentioned for treatment of diabetes mellitus, with Aloe species and Mormodica balsamina being the main ingredients of the remedies administered to patients.Mormodica balsamina is also used as a vegetable by the local people.Aloe sp. and Momordica balsamina have been previously studied and reported to possess some antidiabetic activity (Hassan et al., 2006).Other plant species listed for management of diabetes mellitus were Cassia abbreviata, Opuntia ficus-indica, Tinospora fragosa and Grewia villosa (Fig. 5 and Table 1).

Plants used for sexually transmitted diseases
The treatment of sexually transmitted diseases was a speciality of healers at the area studied.A total of nineteen plant species were mentioned for sexually transmitted diseases.Different species of Aloe as well as Senna italica, Helinus intergrifolius, Ximenia caffra and Tinospora fragosa (Fig. 6 and Table 2) were the main ingredients in traditional medicine preparations for sexually transmitted diseases.Ximenia caffra, indicated for treatment of diabetes and sexually transmitted infections in this study, was shown elsewhere to possess antibacterial activity (Fabry et al., 1998).Fabry et al. (1996) demonstrated the antifungal activity of Ximenia caffra.These findings validate the continued use of the plant species in treating sexually transmitted diseases, especially those caused by fungal and bacterial pathogens.The plant is also used for treatment of venereal diseases in Zimbabwe (Maroyi, 2013).Grewia villosa has been studied for antidiabetic properties (Mondal et al., 2013), phytochemical composition (Bashir et al., 1982) and antibacterial activity (Tanira et al., 1994).

Plants used for infertility and erectile dysfunction
Nineteen plants species were indicated for treatment of infertility and erectile dysfunction.The most used plant species were Tinospora fragosa and Helinus intergrifolius (Fig. 7 and Table 3).The local name of T. Fragosa is "makgonatsohle", and it means it heals all.It is not surprising to find this plant in a variety of mixtures for treatment of many types of diseases.Treatments of sexually transmitted diseases and infertility are overlapping for most of the plants used.It is likely the healers concentrate more on this problem as it maybe one major problem presented in their consulting rooms.

Plants used for stomach ache and vomiting treatment
Fourteen plant species were indicated for treatment of stomach-ache, with Terminalia sericea, Cassia abbreviata, Gymnospora buxofolia, Ozoroa paniculosa and Schotia brachypetala mentioned more frequently by healers interviewed (Fig. 8 and Table 4).Of all the plants listed only Colophospermum mopane was indicated for stomach ache treatments in small children, where the leaves are chewed and spit into the patient's mouth.

Plants used for acquired immune-deficiency syndrome treatment
There is a general belief amongst the interviewed healers that acquired immune-deficiency syndrome (AIDS) is not a viral disease but is associated with witchcraft or "makgoma".Makgoma is a condition perceived to be caused by uncleanliness resulting from death of relative or immoral sexual practices.The interviewees also confirmed that they could not cure AIDS but indicated a number of plants they use for treatment only in the early stages of the disease.Three plant species were listed, viz; Cassia abbreviata, Ozoroa paniculosa and Terminalia sericea (Table 5).

Plants used for cancer and other diseases treatment
The healers had very limited knowledge about cancer.Most of them believed that cancer results from witchcraft.Two plants species come up in the conversation; viz; Combretum imberbe and Dichrostachys cinerea (Tables 6 & 7).All the respondents seemed to agree that different forms of tumours may be classified as "sefolane", which is a word used for any form of growth outside or inside the body, and may result from acts of witchcraft.
The use of Cassia abbreviata is widespread in the village.The plant is used for treatment of diabetes mellitus, sexually-transmitted diseases, symptoms associated with AIDS, infertility and stomachache.In Botswana, C. abbreviata is used for treatment of snake bites (Motlhanka and Nthoiwa, 2013).Some of the claims made by traditional healers have been confirmed by scientific methods of investigation.Hexalobus monopetalus and Zanthoxylum lepriuerii possess antimicrobial activity (Steenkamp et

Plant family names
Plant species belonging to the family Fabaceae were mentioned as a common ingredient in traditional medicines prepared for treatment of a variety of diseases by healers of Mashishimale village.Combretaceae, represented by Terminalia sericea, appeared popular, second after Fabaceae family (Fig. 9).In a separate study conducted in the Vhembe District, plant species belonging to the Fabaceae were common ingredients in medicines used by people of the Lwamondo area (Mahwasane et al., 2013).The Vhembe and Mopani districts are neighbouring sections of the Limpopo Province.There are many aspects of these districts that are common, including cross cultures, vegetation and climate.It is therefore not entirely surprising that Fabaceae family will be used in both districts for traditional medicine preparations.Trees were mentioned more frequently as ingredients in traditional medicines for treatment of a number of diseases, with shrubs a distant second (Fig. 10).

Conclusion
The results of the survey indicate that plants play a significant role in primary healthcare of the community studied.It would seem that each of the major diseases/ailments are treated by traditional methods.Furthermore, information on the use of medicinal plants and the identity of the plants is passed from old generations by word of mouth.Record keeping is very poor and this may mean that in future, the information on components of mixtures, dosages and diseases treated may be lost.Judging by the age of the participating healers, it would seem likely that the younger generations are not taking interest in the practice of traditional medicine, further suggesting that information base is gradually eroding.
This study must be supported by laboratory based investigations to determine the efficacy and safety of the plant species used in traditional medicine.Awareness of the importance of medicinal plants in human healthcare is very important as they have a promising future as potential sources of medicines for many chronic diseases.Many plant species indicated for treatment of diseases have not been subjected to scientific methods of investigation, and the confirmation of their medicinal activities could be a decisive lead in development of treatments of present or future diseases (Rasool, 2012).

Figure 1 :
Figure 1: The area under study.Mashishimale is situated near the town of Phalaborwa, on the north-eastern part of the Limpopo province of South Africa.The town is one of the major copper mining towns in South Africa.

Figure 2 :
Figure 2: An example of a traditional medicine preparation.This is a mixture used to treat fertility in women.It contains Aloe spp and a root of an unidentified plant.

Figure 3 :
Figure 3: Part of plant used for treatment

Figure 4 :
Figure 4: Mode of preparation of plant species

Figure 5 :
Figure 5: Plants used for treatment of Diabetes mellitus

Figure 6 :
Figure 6: Plants used for sexually transmitted diseases

Figure 7 :
Figure 7: Plants used for fertility and erectile dysfunction

Table 1 :
Plants used to treat diabetes mellitus

Table 1 :
Plants used to treat diabetes mellitus (continued)

Table 2 :
Plants used to treat sexually transmitted infections

Table 2 :
Plants used to treat sexually transmitted infections (continued)

Table 3 :
Plants used to treat fertility and erectile dysfunction

Table 3 :
Plants used to treat fertility and erectile dysfunction (continuation)

Table 4 :
Plants used to treat stomach complaints

Table 4 :
Plants used to treat stomach complaints (continuation)

Table 5 :
Plants used to treat AIDS (HIV)

Table 6 :
Plants used to treat cancer

Table 7 :
Other diseases treated