Agricultural clearing, whilst increasing the amount of weedy species used medicinally, has been the major cause of depletion of medicinal plants from forest. Commercial trade in herbal medicines is not well developed, and no sign of large-scale bark or root harvesting was observed in Bwindi Impenetrable National Park.

Photo 12. Rytigynia kigeziensis (nyakibazi), an effective worm remedy, rated as the most important medicinal plant to people in the DTC area.

Collection of herbal medicines is highly species-specific, with over 100 plant species involved, primarily for local use. Leaf material forms the major component of plant parts collected for medicines used to treat people or livestock. "Chewing sticks" used for dental care, are mainly from stems of plants occurring in disturbed areas outside the forest. Most species collected are fast-growing herbs gathered from outside the forest. The impact of medicinal plant harvesting is low, even for favoured species such as Rytigynia kigeziensis (nyakibazi) (Photo 12).

It is recommended that traditional medical practitioners (TMPs) and traditional birth attendants (TBAs) be allowed to collect medicinal plant material from multiple-use zones and that medicinal plant gardens are promoted by both DTC, ICRAF and local clinics through the Ministry of Health.

Traditional medical practitioners (TMPs) and traditional birth attendants (TBAs) play an important role in rural communities throughout Africa. They also have a useful role to play in primary health care (PHC) initiatives.

No data are available on the ratio of TMPs or TBAs to total population in Uganda. There is no doubt, however, that TMPs and TBAs are more numerous than medical doctors, with a medical doctor: total population ratio of 1:20,000 cited by the Ministry of Health (Kakuru, 1990).

In the Kilungu district, Kenya, for example, rural populations of TMPs averaged 1:224 (herbalists 1:665; traditional birth attendants 1:1640 and diviners also 1:665), while in urban Mathare, the overall ratio was 1:883 (Good, 1987). Economic deterioration in the past, and a 3.4% per annum population growth rate, increase the difficulty of providing adequate health services. Although clinics are found in most subcounties, hospitals in the Kabale-Rukungiri districts, located at Kabale, Kisoro, Kisizi and Kambuga are difficult for many people to reach.

Many of the traditional medical practitioners and traditional birth attendants are registered members of TMP or TBA associations, the TBAs using cards associated with UNICEF. Traditional birth attendants (TBAs) (or traditional midwives) play an important role in assisting home births in East Africa. In Tanzania, for example, 75 -80% of births were assisted by TBAs (Anderson and Staugard, 1986). Similarly, in the Machakos area, Kenya, only 26% of pregnant women went to the hospital for delivery (Voorhoeve et al., 1982).

With few exceptions in the DTC area, (the use of naturalized Physalis peruviana, Ricinus communis, or cultivated Pennisetum purpureum, Eucalyptus spp., etc.) traditional medicinal plants are all gathered from the wild.

A good example is the use of Rytigynia kigeziensis (Rubiaceae) bark to treat intestinal parasites ("worms"). Parasite loads are extremely high in the Bwindi/DTC area. In an examination of stool samples from 35 people, 89% (31) were infested with roundworm (Ascaris), and 34% (11) with whipworm (Trichuris) nematodes, in addition to ten other types of intestinal parasite (Ashford et al., 1990). Many local people encountered during this survey expressed the view that if they did not have continued access to Rytigynia kigeziensis (nyakibazi) bark, "they would die". Sustainable use of medicinal plants is therefore essential, and the focus here remains on key medicinal plants or on those that are commercially traded.

Sustainability of medicinal plant use

Outside the national park, Afromontane forest which was a source of traditional medicines in the past has declined drastically through clearance for agriculture. Exclusion from Bwindi Impenetrable National Park thus affects TMPs who previously gathered medicines there. TBAs, who gather most of their medicinal plants in disturbed sites outside of the forest, are less affected by restrictions. In addition, supplies of herbal medicines to TMPs are affected by competing uses such as timber logging (e.g. for Entandrophragma excelsum, omuyovi). There is therefore growing demand for fewer resources.Although a large number of plant species are used by TMPs, impact on medicinal plant resources is reduced by three factors:

1. the low ratio of TMP and TBA to total population, and small quantities of medicinal plants gathered for use by TMPs and TBAs;
2. the low level of urbanization in Uganda (6% of total population), compared to many other African countries, and the correspondingly low level of commercial trade in traditional medicines. In Owino market, Kampala, for example, 10 - 12 men sold traditional medicines in small quantity. By contrast, traditional medicines are sold in bulk in large cities such as Abidjan, Côte d’Ivoire (107 bulk sellers) and Durban, South Africa (392 bulk sellers, over 100 retail shops), generating a long-distance, species-specific trade which threatens popular medicines within rural areas (Cunningham, 1990). It is worth noting, however, that a small-scale trade in traditional medicines has developed, with bark, roots and other parts of favoured traditional medicines ordered from people living near to Bwindi Forest (Table 5, Photo 13). In 1992, a single herbalist was buying herbal material;
   

   Photo 13. The start of commercial trade in the DTC area: bark from Entandrophragma excelsum (omuyovi) sold by a herbalist at the main village centre.

3. the fact that (in this study at least), leaf material was the most common part of the plant used by TBAs (Photo 14, page 22) and cattle owners. Although data are incomplete, a preliminary analysis of life forms and parts used by TBAs suggests that of the plant parts used, at least 62% (96 of 154 species) is leaf material, mostly from herbs growing outside the forest.

Photo 14. Herbalist Mr. M. Mafurira with leaf material which forms a major part of herbal medicines.

The three most important categories of uses of medicinal plants by TBAs were for symbolic or magical purposes (as protective charms against bad omens, to ensure safe journeys or assist in love affairs and court cases) [22% (34 species)]; to assist women either prior to, or shortly after childbirth (preventing premature labour, assisting labour, removal of placenta, treating swollen breasts or improving lactation) [18% (29 species] and for treatment of internal parasites ("deworming") [7% (11 species)].

By comparison, in this preliminary analysis, leaf material (37% (17 of 46 species) was also the largest plant part category used by TMPs, but came from a wider range of life forms (trees, shrubs and climbers, in addition to herbaceous plants). The three major categories of use were to treat stomach aches [15% (7 species)] and internal parasites ("worms") [13% (6 species)] and for use as antidotes to poisons (often those administered by jealous rivals) [11% (5 species)].

From field observation, it appears that the impact of medicinal plant gathering is low. Only two large specimens of over 70 Rytigynia kigeziensis trees seen showed signs of bark removal, despite the popularity of this species as a key medicinal plant. Both of these were large plants adjacent to paths. Debarking of Hallea rubrostipulata was observed outside, but not inside the national park. By comparison, debarking by elephant of trees such as Macaranga kilimandscharica (omurara), Prunus africana (omumba) and Rytigynia kigeziensis (nyakibazi) is much greater.

Dental care: chewing sticks

Dentists are scarce in many parts of Africa, particularly in rural areas. The ratio of dentist to total population in Ghana for example, was 1:150,000 (compared to 1:3000 in Great Britain) (Adu-Tutu et al., 1979).

Although diet plays a major role in incidence of dental caries, dental hygiene is also important. While toothpaste and toothbrushes are widely used by the sector of the population with a high level of formal education, toothpaste is expensive and sometimes not available in rural areas.

In the DTC area, in common with many rural areas in Africa, traditional toothbrushes or "chewing sticks" from thin branches or roots of local plants are still in common use.

Continued access to popular and effective sources of chewing sticks, many of which have anti-bacterial properties, is important. Unlike the situation in West Africa, where a thriving trade in chewing sticks has developed, use here is for local purposes only and the impact on vegetation is negligible.

Seven species used for dental care were identified in discussions at Buhoma. All were obtained outside the forest, from disturbed sites near to villages and homes; these were stems of omuhuke (Lantana trifolium), omusinga, omukyindezi, omuchundura, omusambya (Dodonaea viscosa) and the leaves of two species (ekarwe and omufumbwa).

Traditional veterinary medicines

Although pastoralism is not the major form of land-use in the DTC area, cattle still have important economic and social significance in this area. Veterinary medicines and formally trained veterinary doctors are scarce and expensive, and wild plants are commonly used to treat a wide variety of livestock diseases in cattle and goats. Knowledge of traditional veterinary medicines is more widespread than knowledge of medicinal plants used to treat people. Over 20 different types of ailments affecting cattle are recognized. Leaf material forms the bulk of plant parts used (64%, 16 of 25 species, %%) of this small sample. Many of the plant species occur outside the forest. There is no commercial trade in plants for veterinary medicines, impact is considered low and the current level of use sustainable.

More detailed work is required on traditional veterinary medicines before firm conclusions can be drawn on major ailments treated in livestock. This preliminary survey showed that the most commonly used remedies were for diarrhoeal disease (khitwa), swellings on the legs, ears or groin of livestock (ekibagarila), mastitis and swellings of the udder and teats of cows.

Traditional medicines and hunting dogs

Hunting to provide meat and reduce numbers of crop raiding animals such as bush-pig has been an important recreational activity in the DTC area in the past. In the past, dogs were used to run animals down, or to drive them into nets (Butynski, 1984). Dogs are still used for hunting in small patches of scrub and forest outside Bwindi Forest, with one hunt seen during this survey.

Traditional medicines, with symbolic and possibly also physiological value, are widely used in Africa to improve the aggressiveness, sense of smell and hunting ability of dogs. In the DTC area, the use of five plant species was recorded: the bark of Tabernaemontana odoratissima (kinyamagozi) and Schefflera barteri (omwamira), the fruit of Coccinia mildbraedii and another Coccinia species (omutanga), and the leaves of Thalictrum rhynchocarpum (omwitango). Small quantities of these plants are used, and impact is considered to be negligible.

Basketry

Basketry combines traditional skills and local materials to produce a range of woven articles for storage and processing of agricultural crops or home use. Plant materials used vary from fast-growing, productive wetland species (e.g. Cyperus papyrus, efundjo) to scarce, slow growing climbers that are found at low density in forest (Loeseneriella apocynoides, omujega).

Many species favoured for basketry are common in disturbed sites and over-exploitation is unlikely. Specific recommendations are made regarding two climbers that are popular for certain woven baskets: Smilax anceps (enshuli) and Loeseneriella apocynoides (omujega). The second of these species is of greatest concern from a sustainable use viewpoint. Clearing of forest for agriculture, followed by recent development of the tea industry led to increased use of Loeseneriella apocynoides for tea-baskets in addition to other competing uses (for granaries, stretchers and as a general purpose binding material), resulting in over-exploitation.

Almost without exception, households in the DTC area use baskets for harvesting, drying, winnowing, grinding and storing agricultural produce. Basketry techniques and plant materials are also used to weave granaries, fish-traps and stretchers.

Although alternatives (e.g. plastic bags) are occasionally used, indigenous plants are the major source of basketry fibre (Table 6). Despite their widespread use, skilled basket-makers are relatively few in number, particularly for specialized baskets made by men, such as winnowing trays and stretchers.

Photo 15. Carrying baskets (etchitukuru) for sale at Batogota market.

The most widely used baskets are the flat, circular baskets which are placed adjacent to the grinding stone to collect ground flour (orugali), the deep, bowl-shaped millet basket (echibo), a larger and shallower bowl-shaped basket for grain (entemere), a larger basket for carrying headloads of crops (etchitukuru) and the winnowing basket (entara). The first three basket types are mainly made by women, using a coil-foundation technique with grass (Eleusine indica, enchenzi) and papyrus (Cyperus papyrus) for the coils, and Plantago palmata flower-stalks for the dark design. Women also make mats (omucheche) for sitting or sleeping on, as well as for drying millet (etchigaru). These are made from Cyperus latifolius leaves, bound with twined Triumfetta (omunaba) bark, sometimes with dark banana fibre woven in for a decorative pattern. The etchitukuru basket is woven using a chequer-weave by both men and women, using either Smilax anceps (enshuli) or bamboo (Arundinaria alpina), and is the type of basket most commonly sold at markets (Photo 15).

The entara winnowing basket is made mainly by men, using a chequer-weave, often from Smilax anceps (enshuli) weft and Grewia sp. (omutahendeka) warp. A basket that is probably made more commonly now than in the past is the "tea-basket" (orutete), which is preferentially made from Loeseneriella apocynoides (omujega), but as this climber has become scarce, it is also being made from leaf-stems of Phoenix reclinata (enchindo). Tea-baskets are also made mainly by men. Thick (2-4 cm) climbers are used, and split into thinner strips. All basket fibres can be stored in a dry place for later use, and are soaked before weaving.

Stretchers (engozi)

Photo 16. Woven stretcher, with weft of Smilax kraussiana (enshuli) and warp (length wise) of Phoenix reclinata (enchindu), supported by bamboo poles (the exotic Bambusa sp). Ishasha area, May 1992.

Woven stretchers (engozi) (Photo 16) play a very important role in rural communities in the Rukiga highlands for the transport of sick (or dead) people. With the exception of Phoenix reclinata (enchindu) leaf-stems they are entirely constructed from forest plants (see Table 6) and are a mainstay of stretcher-bearer societies (ekyibinachengozi (ekyibina = society; engozi = stretcher)) that are something like a local medical aid association.

These associations are well organized, with a chairman and secretary. Monthly financial contributions are made by men (c. 200 shillings per month) and women (c. 50 shillings per month) to cover the cost of food for journeys and for buying new stretchers, which last 2-4 years, depending on the materials used, the toughest material being Loeseneriella apocynoides (omujega).

There is usually one association per "cell" and usually 7-8 per parish. Stretchers are made mainly by men, who sometimes also weave winnowing baskets, and there are very few of these specialists within the DTC area. There are none in the Ruhija area, for example, and society members have to get stretchers from the Rubanda area. Similarly, the single stretcher weaver in the Rushaga area reportedly supplied stretchers to stretcher-bearer societies in the Rubuguli, Remero and Kaara parishes.

Granaries

Photo 17. Granary in the DTC area constructed from the forest climber Loeseneriella apocynoides (omujega), thatched with Imperata cylindrica (Bujengwe parish, adjacent to Kitahurira).

Post-harvest loss is a worldwide problem, with losses of cereal crops of between 10-20% in developing countries (FAO, 1981). From discussions with local farmers, the DTC area is no exception, whether due to insects, fungi or less commonly, baboons breaking into a poorly made granary to eat finger-millet. Resolving this problem complements attempts to increase food production and improve food security being undertaken by CARE-International. Granaries are the major means of storing crops in the DTC area and are found at every homestead. Men construct most granaries, with two basic types made: a smaller, tightly woven type for beans, and a larger granary for grain (finger millet, sorghum) and root crops (sweet potatoes, potatoes).

Materials used, and quality of construction vary considerably, however (see Table 6). These include crop surplus such as sorghum stalks, cultivated plants like Pennisetum purpureum (elephant grass) or forest plants like bamboo and various climbers (Photo 17).

Sustainability of basketry resources

For resource management purposes, basketry materials could be divided into five categories:

1. species common in disturbed sites such as roadsides and old fields: Eleusine indica (enchenzi), Plantago palmata (embatambata);
2. locally common wetland species: Cyperus papyrus (efundjo), C. latifolius (ekigaga);
3. bamboo, climbers, and a scandent shrub of disturbed scrub and forest, with Smilax anceps (enshuli) and the scandent shrub Grewia sp. (omutahendeka) most popular, followed by the high altitude bamboo, Arundinaria alpina, and then to a lesser extent Urera hypselodendron (omushe) and Flabellaria paniculata, which are used for "bush rope" or for granaries;
4. members of the Marantaceae restricted to moist valleys and gullies in lower altitude (1500-1750 m) sites in the forest - Marantochloa leucantha (omwiru) and Ataenidia conferta (ebitatara); or the palm Raphia farinifera (Arecaceae) which is also restricted to moist valleys in the Nteko and Buhoma areas at 1500 m;
5. climbers in the Celastraceae found in older secondary forest and mature forest. The most widely used is Loeseneriella apo-cynoides (omujega) and Salacia sp. (bwara), with others being Hippocratea odongensis (oruyangaro) and Salacia elegans (orudyangara).

These categories represent increasingly scarce species with more and more specific habitat requirements.

Categories 1 and 2 are common and widespread, and their use would be sustainable. Basketmakers select patches with a high density of Eleusine indica or shady sites where Plantago plants have longer flower-stalks more useful for coil-built basketry, or cut small quantities of Cyperus latifolius leaves or young culms of C. papyrus.

Category 3 is limited to forest or forest margins, with the climber species common in canopy gaps. Of these four species, Smilax is in the greatest demand, despite the difficulty of working with this tough material. Although widespread in disturbed sites in East, Central and southern Africa, it is considered scarce by basketmakers in the DTC area due to the intensive land-use around the forest, with fallow periods too short to enable its dispersal and growth. Exceptions to this is the Nteko area, where population densities are lower, and forest patches still occurring outside Bwindi Impenetrable National Park. Harvesting is probably higher along paths or roads where disturbed sites are more accessible. Thicker stems are used, and although local over-exploitation takes place, recruitment with regeneration from the root-stock, combined with dispersal by birds into forest margins and disturbed sites is thought to avoid depletion of plants within forest patches. Regeneration time for Smilax was considered to be 6-12 months by resource users. Bamboo use is discussed below (page 27). Use of Urera hypselodendron and Flabellaria is limited to granaries, and impact is considered negligible.

Category 4: The cuticle of leaf-stems (both Marantaceae) or of young leaves (Raphia) is used. This limits harvesting impact on the plants, although they are only locally common in moist valleys. If commercial harvesting is developed to satisfy large-scale commercial production, then a management problem could arise due to high intensity and frequency of defoliation, and possibly also to trampling or uprooting of these plants. This has been recorded elsewhere for usually resilient mat-rush (Juncus) and palm (Hyphaene) species in southern Africa (Cunningham and Taylor, 1983; Cunningham and Milton, 1987). Baskets from Raphia cuticle are only made on a limited scale, and impact is considered to be negligible.

Category 5: The impact of cutting Salacia sp. (bwara), Hippocratea odongensis (oruyangaro) and Salacia elegans (orudyangara) for granaries is unknown, but from discussions with local resource users is judged to be far less than that on Loeseneriella apocynoides (omujega), which is considered to be the slowest growing of these forest climbers. It is also in greatest demand for a wide variety of uses, from a general purpose "bush rope" of exceptional strength, to use for tea-baskets, stretchers and granaries. According to resource users, it takes 10-20 years for Loeseneriella apocynoides to reach a high quality useable diameter (3-4 cm), although there are no data on climber growth rates to confirm this. From field observation, however, it is clear that L. apocynoides occurs at a low density in lower altitude (1500-1750 m) forest (e.g. Buhoma area), with single specimens seen in the Ihihizo and Ishasha valleys. Plants appear to sprout after cutting of the large stems, and presumably this removal of large stems represents loss of mature stems producing flowers and seeds.

Loeseneriella has come under markedly increased harvesting pressure with the development of the tea industry around Bwindi Impenetrable Forest, as it is the most favoured species for making tea-baskets. According to data from the Uganda Tea Growers Corporation (UTGC) factory at Batogota, there are 1597 out-growers in the DTC area. Assuming that there are three pickers per out-grower, each with a basket made from L. apocynoides (weighing c. 500 g and said to last four years), this would represent the use of 2.4 tons of this climber every four years (or approximately 600 kg per year). With the low density of this species in the forest, presumably indicating old canopy gaps, tea basket making has had a major impact on this climber, in addition to its use for stretchers and granaries. A stretcher maker in the Rushaga area, for example, reported having to travel an estimated 5 km into the forest (almost to Mubwindi swamp), spending two days to collect enough material to make a stretcher. Scott (1992) also encountered many resource users, including tea-pickers, who were having increasing difficulty in obtaining this species.