ceptions, non-Africans oft en think of the African continent as
dark, dirty, and diseased. However, a detailed look at the pre-
history of the continent and an examination of information
derived from research that sheds light on the past shows that
Africans have developed long-standing and fl exible systems
of health that have allowed them to treat and cope with a wide
range of diseases and other health concerns. What we know
about Africa today and about the past suggests that some of
the most important concerns of the residents of Africa in
ancient times included the health and welfare of infants and
children, fertility, calamitous events, and their relationship to
the environment in which they lived. Many healing practices
undoubtedly addressed these types of concerns, along with
broken bones and the specifi c, widespread diseases such as
malaria, schistosomiasis (infection with a parasitic worm),
and sleeping sick ness that probably aff ected some inhabitants
of the continent during the ancient time period.
As in modern times, diseases were closely connected
to the environment in which humans lived on the African
continent. Understanding the human inhabitants’ natural
and cultural environments is crucial to comprehending the
experiences with health and disease that those humans had
during the ancient era. Th e fact that humans and their bio-
logical ancestors have a long history of residence on the Af-
rican continent probably means that the viruses, parasites,
and other causes of diseases in humans have an equally long
history on the continent. Th ese diseases and their carriers
have evolved in concert with the human populations that
they infect. Th e natural environment—whether tropical for-
est, savanna grassland, or arid desert—shaped the nature
of health and especially disease. Diff erent conditions either
did or did not lend themselves to specifi c diseases and other
health concerns.
Water, as a direct carrier for diseases and as a breeding
ground for other carriers of disease, especially mosquitoes,
was a key part of the environment that directly aff ected Afri-
cans’ ability to remain healthy. Malaria and schistosomiasis
are both closely linked with the presence of bodies of water
and were probably particularly prevalent in communities
engaged in agriculture, especially agriculture involving ir-
rigation. Th e absence of water, in the form of drought, was
also a frequent health concern. In the search for a healthy bal-
ance with their environment, Africans probably used healing
practices both to ensure enough water to support their lives
and to treat illnesses associated with water-borne illnesses.
Africans also shaped their environments culturally in
terms of their settlement patterns, their economic activities,
and their beliefs and associated behaviors. Th ese cultural en-
vironments created circumstances that helped reinforce the
likelihood of health or disease. Many of the inhabitants of the
African continent during this time period lived in relatively
small groups that were oft en fairly mobile. Th ese cultural
characteristics meant that they were less subject to large-scale
epidemics and other health concerns associated with bigger
settlements and the domestication of plants and animals. On
the other hand, their health was oft en a direct product of the
unpredictable natural environment, which was sometimes
unfriendly. Residents of the continent who depended on do-
mesticated plants and animals may have had more protection
from some of the vagaries of the natural environment, but
they most likely also experienced more problems with mal-
nutrition and the transmission of disease among humans and
between animals and humans.
Th e study of human cultures and historical evidence
suggests that African cultures tended not to compartmen-
talize health by separating it completely from other impor-
tant activities and concerns. It seems reasonable to assume
that many African cultures in ancient times had a similarly
broad understanding of health and healing. Health tended to
be thought of in physical, mental, and social terms. Healers
who were sought out to treat diseases and physical ailments
probably oft en provided other services, such as protection
from witchcraft , magic to ensure success in hunting or ag-
riculture, and medicines to protect infants from harm. Th e
fact that healers frequently dealt with a wide range of issues
signals the ways in which health blended together with issues
of economics and politics as well as religion and spirituality.
Sometimes the medicines and treatments were widely known
by members of a particular society; in other cases, medicines
and treatments were known only by specialist healers. Indi-
viduals with specialized healing knowledge oft en occupied
positions of political and religious authority. Th erefore, heal-
ers were important fi gures in many African societies during
ancient times.
Healers seem to have practiced both imitative (or “sym-
pathetic”) and contagious magic, where certain magical acts
are performed or formulas followed in the hope of eff ecting
the desired end, whether it is to improve crops or heal ill-
ness. In sympathetic magic, for example, it is thought that
acts performed on ritual objects (such as a doll that stands
in for an actual person) will transfer to the person. Prehis-
toric art forms have been interpreted to indicate that art was
part of the practice of imitative magic, designed to ensure the
success of the hunt or other desired outcomes. In contagious
magic it is thought that things or persons that have once been
in contact can aft erward infl uence each other. Along these
lines, it seems likely that healing practices involved elements
of imitative and contagious magic as well as detailed knowl-
edge of the medicinal properties of locally available plants
and minerals and other resources. Th ese healing practices,
supported by substantial knowledge, are indicative of the
sorts of cultural responses to disease and ill health that would
undoubtedly have been found on the African continent in an-
cient times. Humans on the continent sought to ensure their
health and to treat diseases using a combination of spiritual
and physical means.
In all, the physical and cultural environments shaped
both health and disease for residents of the African continent
during ancient times. Healing practices designed to ensure or
to restore health responded to elements of nature as well as to546 health and disease: Africa