Herbal Healing: An Old Practice for Healthy Living among Khumi, Marma and Tripura Communities of Thanchi Upazila, Bangladesh

Background: At present, only a limited amount of documentation exists that shed light on aspects of plants used by Traditional Healers (THs) in Bangladesh for treating general ailments. The current study is concerned with information on medicinal plants (MPs) used in Traditional Medicine (TM) by the Khumi, Marma and Tripura communities of Bangladesh. Aims: The study attempted to collect, analyze and evaluate Traditional Knowledge (TK) of the healing powers of plants used in TM in Thanchi upazila during August 2011 to January 2013; and to classify as far as possible the plants encountered in the study. Methodology: Semi-structured questionnaire was used to collect information through Focused Group Discussions (FGD) and one to one discussions with the selected indigenous Original Research Article Motaleb et al.; EJMP, 5(1): 23-52, 2015; Article no.EJMP.2015.003 24 community people. Results: A total of 91 different diseases (faced by the above three communities of the study area) were recognized that were treated by the THs using 116 herbs and shrubs belonging to 50 different families. Scientific name of different plant species, parts used, preparation process including doses, and names of user communities are also mentioned. Conclusion: This documentation will encourage the relevant stakeholders, authorities and conservationists in emphasizing the proper management of TK, including the conservation initiatives.


INTRODUCTION
Plants, plant parts and plant products of all descriptions, particularly those with medicinal properties, have been used since time immemorial as principle ingredients of various traditional medicines [1]. The history of use of MPs for alleviating illnesses had its origin in the activities of early humans. Selection of MPs by such humans, without any prior knowledge, was largely based on intuition, guesswork or trial and error. The healing powers (HPs) of some plants were often discovered by accident. Thus, by a combination of these processes there emerged a considerable body of knowledge of MPs that was transmitted from one generation to another. At first, orally; and later, in written form as papyri, baked clay tablets, parchments, manuscripts, and finally as printed herbals, pharmacopoeias and other works [2]. Our ancestors, through trialand-error, discovered useful natural substance that they came across to ease their discomfort and sufferings caused by various acute and chronic illnesses or injuries. Since ancient times, plants with therapeutic properties have occupied an important niche in the disease treatment practices [3].
Bangladesh a small country, occupying an area of about 147,570 sq. km, is endowed with a very favorable climate for diverse flora. A great variety of plants grow in her forests, agricultural lands, barren lands, waste lands, water bodies, homesteads, and also along the roadsides. Many of these plants are often considered as weeds which contain active substances with medicinal properties. It has been recorded that about 450 to 500 plants growing or available in Bangladesh tend to hold therapeutic values [4]. The rich heritage of indigenous knowledge associated with TMs is considered as the basis of all systems of traditional remedies in Bangladesh. Most of the medicinal plants of Bangladesh are extensively used in the preparation of Unani and Ayurvedic medicines. These plants also serve as important raw materials for many modern medicinal ingredients [3]. Unfortunately, these valuable assets have been depleting rapidly because of unsustainable exploitation and land use changes [5].
Until now, few communities of Bangladesh, especially the indigenous people of CHT, have been traditionally using TMs. It has been unequivocally established that medicinal plants and related knowledge, that represent a part of rich local heritage, play a significant role in the general welfare of the upland communities of CHT [6,7]. The ICs of this area traditionally rely on TM due to their belief, culture and availability of the plant resources. On top of that, due to the absence of modern treatment facilities, they fully depend upon nature for their regular treatment. But in recent time, availability of medicinal plants and associated TK fell under threat of extinction due to depletion of MPs and THs practice respectively. That is why the need for documentation of these priceless resources is very urgent. Different countries have given emphasis on this documentation namely, Srivastava and Rout [8], Parkash et al. [9], Srivastava and Adi Community [10], Zheng and Xing [11], Telefo et al. [12], Rehecho et al. [13], Ayanar and Ignacimuthu [14], Sargin et al. [15] and Ullah et al. [16].

RESEARCH METHODOLOGY
A team was formed with plant taxonomist, silviculturist, forester, biologist, and local herbal healers. Extensive field surveys were carried out for the last one and half year years (August 2011 to January 2013). Three relevant skilled persons from a local NGO, Bolipara Nari Kalyan Somity (BNKS), were also involved in the team who interpret the local language of the tribal people.

Study Area
The study was conducted among the Khumi, Marma and Tripura community of Thanchi upazila (longitude 21°78' and latitude 92°42') of Bandarban that is situated in the southeastern corner of Bangladesh. Marma is the most dominant IC in this area; other communities included are Khumi, Mro, Bawm, Chak, Tripura etc. Jhum (shifting cultivation or slash and burn cultivation) is the traditional method of crop production in this area. Livestock rearing also makes up a significant proportion of livelihoods of the communities. Numerous traditional, religious and cultural rituals and norms bind these societies together. Compared with the entire country, Thanchi upazila ICs suffer from a high proportion of extreme poverty, with very low food security, low supplies of safe drinking water, inadequate sanitation facilities, extremely low literacy rate. Species information was collected using a  pretested  semi-structured  questionnaire  (including who, what, how, when, by whom and  why the plants are used) through FGD, one to  one  discussions  with  the  local THs. Simultaneously, more information was gathered from local knowledgeable persons, Buddhist monks, and elderly men and women. During FGD, the informants came on mostly used medicinal herbs and shrubs and then the information of local name, parts use, herbal use, preparation process, local status and measures taken to conserve each species were recorded. A particular plant was picked up and queries were made as to how it emerges to be useful for them. After finishing interview for one particular plant, a second plant was taken up and so on. The investigation was very effective and informative because of the fact that the information were collected and recorded through consultation with various indigenous communities such as Marma, Tripura and Khumi, who use these medicinal plants mostly and finally verified by various informants at different spots. Once the information on a particular plant was considered as reliable after repeated discussions, then its local name and uses were recorded. Most of the species were identified by the taxonomist of the study team. The unidentified species were preserved in the herbarium and identified by the taxonomists of Bangladesh National Herbarium, Department of Botany of Dhaka University, Bangladesh Forest Research Institute (BFRI), Institute of Forestry and Environmental Sciences of Chittagong University. Direct filed visit in the hills, streams and forests were also conducted to gain knowledge in regards to the ecology, habitat and other important issues for all the species. The authenticity of information on each species was confirmed through repeated interviews. Prior Informed Consent (PIC) was taken from the knowledge providers before collecting information. Later, the compiled information was shared with them in their own local language.

RESULTS AND DISCUSSION
The herbal healing techniques of Khumi, Marma and Tripura communities of the study area have been presented in Tabular form in Table 1. Diseases are arranged alphabetically by their English names. Then species that are used to treat different diseases, plant parts used for treatment, brief preparation process of the TM and IC users have been arranged in Table 1.
Besides, a short scenario of a number of plants having different pharmacological actions, frequently used plants parts to treat diseases and modes of providing herbal treatment are shown in Fig. 1, Fig. 2 and Fig. 3 respectively.
Present study revealed a total of 91 different diseases that are treated by the THs of three communities by using 116 different herbs and shrubs belonging to 50 families. The findings support the similar studies, e.g., [40] listed 60 species from 40 families used by Chakma, Marma and Tanchunga; [31] found 70 species from 36 families common among Bwam, Marma, Murang and Tanchunga tribes. The current study also found that species under Rubiaceae family (9 species) were mostly used by them; followed by Fabaceae (8  species); Asteraceae, Euphorbiaceae, Lamiaceae and Zingiberaceae (6 species each); Araceae, Caesalpinaceae and Verbenaceae (5 species each); Apocynaceae (4 species), and Amaranthaceae and Menispermaceae (3 species each).
Number of plants having differ pharmacological actions are shown in Fig. 1. It illustrates the diseases which are cured by 3 and above number of plants. It was observed that, to treat disease like headache they use maximum number of plants (12) followed by stomachache and abdominal pain (11) gastritis (9), sore (8) fever for all ages (7), asthma and allergy (6); wound, menstrual problem (irregular menstruation), ear pain, different types of cut, conjunctivitis, and burning (5). From the above results, it could be concluded that indigenous peoples like more options for their regular treatment purposes. For example, headache, stomachache, abdominal pain and gastritis are very common diseases in Bangladesh for which maximum species are used.
Among the plant parts used, leaves (98) were highly utilized followed by root (50); whole plant (41); rhizome (21); flower (14) and young leaves (13) (Fig. 2). Modes of providing treatment fall into fourteen categories. A maximum of 108 formulations were reported to be used in the juice or liquid form; whereas, 61 in paste form; 18 in bath with plants or plant parts boiled water; and 10 in powder form. The other categories were reported less frequently (Fig. 3). Commonly prescribed medicine doses (e.g. Pills, powder etc.) are rarely found for treatment due to lack of well-structured herbal healing. However, the result clearly depicted that at the primary stage these communities are fully dependant on their traditional healing system (e.g. Juice, paste etc).

. Frequently used plant parts to treat different diseases
It was exposed that out of 116 species, Marma community used the highest number of species (98), followed by Khumi (84) and Tripura (67) to treat different diseases, though some species were used by more than one community. It was also revealed that the above mentioned three communities commonly used 52 species (Fig. 4).

CONCLUSION
It is very unfortunate that limited work has been done so far by the natural scientists to document the TK of the THs about their healing practices of Bangladesh and hence we need to take some measures for protection of this knowledge. Conservation of rare and important medicinal plants through ex-situ and in-situ conservation might be the best mode of protection. Organized motivational and awareness raising campaign for local people should be conducted. On the other hand, training should be provided to the local farmers about nursery and plantation techniques on medicinal plants to get good results. Formation of a social-knowledge-service-network between the THs and other stakeholders will help to protect the TK related to medicinal plants.