Root Workers, Midwives, and Herbalists: The African Healing Traditions America Tried to Erase

There is a particular kind of violence in being told that what you know is not knowledge. It does not leave bruises. It operates through licensing boards, through courtrooms, through medical school curricula that begin their histories in ancient Greece and skip three continents entirely. For African and African American healers across four centuries of American history, this epistemic violence accompanied and often preceded physical persecution — the confiscation of herb bundles, the prosecution of midwives, the pathologizing of healing ceremonies as superstition or sorcery.

The story of how African medical traditions were marginalized in America is inseparable from the story of how race was constructed as a category of intellectual and civilizational hierarchy. To understand one is to illuminate the other.

A Continent of Medical Knowledge

African medical traditions are not monolithic, and treating them as such is itself a form of distortion. Across the continent's diverse ecological zones and cultural regions, distinct healing systems evolved over millennia in response to specific disease environments, available pharmacopeias, and cosmological frameworks. The Yoruba tradition of Ifa, practiced across what is now southwestern Nigeria and the Benin Republic, integrates botanical medicine with divination and psychological counseling in ways that contemporary ethnobotanists have recognized as remarkably sophisticated diagnostic systems. The Zulu concept of ubuntu — roughly, the understanding that individual health cannot be separated from communal well-being — anticipates by centuries the social determinants of health framework that now anchors progressive public health policy in the United States.

In East and Central Africa, bone-setting techniques and surgical practices documented by early European travelers were frequently described with grudging admiration even by observers ideologically committed to African inferiority. Scottish missionary David Livingstone recorded witnessing surgical procedures in the 1850s that he acknowledged produced outcomes comparable to, and in some cases superior to, contemporary European practice.

Enslaved Africans brought fragments of these traditions with them across the Middle Passage — seeds hidden in hair, plant knowledge carried in memory, healing protocols transmitted through community practice under conditions designed to destroy every other form of cultural continuity.

Healing Under Bondage

On American plantations, the figure of the enslaved healer occupied a position of profound ambiguity. Enslavers recognized, out of economic necessity, that keeping enslaved populations alive required medical attention — attention that plantation owners were frequently unwilling to pay white physicians to provide for Black patients. Enslaved healers, particularly women who served as midwives and herbalists, filled this gap.

The knowledge these practitioners held was extensive and empirically grounded. Historian Sharla Fett, in her landmark study Working Cures: Healing, Health, and Power on Southern Slave Plantations, documents how enslaved healers maintained sophisticated pharmacological knowledge — using plants including boneset, pennyroyal, and various species of the genus Datura in ways that reflected genuine understanding of their chemical properties, not merely superstition. Some of these preparations have since been validated by modern pharmacognosy.

Yet this same knowledge made enslaved healers objects of suspicion and fear. The ability to heal implied the ability to harm. Accusations of poisoning — sometimes legitimate, often fabricated as a mechanism of social control — followed enslaved herbalists throughout the antebellum period. In South Carolina, a 1751 law specifically targeted enslaved people who "instructed" others in the use of plants, reflecting white anxieties about a knowledge system they could not fully surveil or control.

Midwifery was perhaps the most contested domain. Enslaved and later free Black midwives delivered the majority of babies born in the rural American South — to both Black and white mothers — through the nineteenth century and well into the twentieth. Their safety records, where they have been reconstructed from mortality data, were frequently comparable to or better than those of formally trained white physicians. This did not protect them from displacement.

The Professionalization Project and Its Racial Architecture

The late nineteenth and early twentieth centuries witnessed a systematic campaign to consolidate medical authority in the hands of university-trained, licensed practitioners — a process that the medical establishment has largely narrated as the triumph of science over ignorance. The Flexner Report of 1910, commissioned by the Carnegie Foundation and authored by Abraham Flexner, is the pivotal document in this story. It resulted in the closure of more than half of American medical schools, including five of the seven Black medical institutions then in operation.

The explicit racial logic of the Flexner Report has been extensively analyzed by scholars including Dr. Harriet Washington in her essential work Medical Apartheid. Flexner's recommendations were not value-neutral assessments of scientific competence. They were instruments of a professional consolidation that used the language of rigor to achieve the outcome of racial exclusion — limiting Black Americans' access both to medical training and to practitioners who shared their cultural frameworks and community trust.

Simultaneously, state-level licensing regimes criminalized the practice of midwifery and herbal medicine outside formally accredited channels. Granny midwives — the community-based birth practitioners who had served Black rural communities for generations — were progressively regulated out of practice across Southern states between the 1920s and 1970s. The public health rationale offered for this displacement has been challenged by demographic historians who note that the transition to hospital birth did not uniformly improve outcomes for Black mothers, who faced (and continue to face) elevated mortality rates in clinical settings shaped by racial bias.

Living Traditions, Contemporary Reclamation

The suppression was never total. African American healing traditions persisted through churches, through informal community networks, through the kitchen knowledge of grandmothers who knew which plant reduced fever and which tea eased labor. In urban communities, root workers and spiritual healers maintained practices that blended African cosmological frameworks with Christian imagery and New World botanical knowledge — a syncretic tradition that scholars of African diaspora religion have documented with increasing rigor.

Contemporary reclamation takes multiple forms. Community health workers in cities including Atlanta, Baltimore, and New Orleans are integrating traditional plant medicine into neighborhood health programs, working alongside rather than in opposition to biomedical practitioners. Academic ethnobotanists at institutions including the University of Florida and Emory University are conducting peer-reviewed research on African diaspora plant medicines, several of which have demonstrated significant pharmacological activity in preliminary trials.

The birth justice movement, led by organizations including the National Black Midwives Alliance and SisterSong Women of Color Reproductive Justice Collective, is working simultaneously to restore community-based midwifery practice and to address the structural racism in obstetric care that makes Black women in the United States two to three times more likely to die from pregnancy-related causes than white women — a disparity that exists independent of income or education level.

The Epistemological Stakes

What is ultimately at stake in this history is not merely the recovery of useful remedies or the rehabilitation of individual practitioners. It is a question of what counts as knowledge, who is authorized to produce it, and whose suffering is rendered legible by the frameworks we use to understand health and disease.

African healing traditions operated from premises — that the individual cannot be healed in isolation from community, that emotional and spiritual states are physiologically consequential, that the healer's relationship with the patient is itself therapeutic — that biomedicine is only now, haltingly, beginning to incorporate into its own models. The suppression of these traditions did not merely harm the communities it displaced. It impoverished the broader project of understanding human health.

Recovering these traditions, as the practitioners and scholars doing this work understand, is not nostalgia. It is an epistemological correction — a recognition that knowledge has never been the exclusive property of any single civilization, and that what was criminalized was not ignorance but a different, and in many respects complementary, way of knowing.