Ethnobotanical study of medicinal plants used by local people in Menz Gera Midir District, North Shewa Zone, Amhara Regional State, Ethiopia

This study was conducted in Menz Gera Midir (Ethiopia) to document medicinal plants and related indigenous knowledge of local people. Data were collected from 72 (12 of them key) informants using semi-structured interview, group discussion and guided field walk. Priority ranking, paired comparison and direct matrix ranking were used in data analysis. A total of 155 medicinal plant species, 104 (67.1%) from natural vegetation and 51 (32.9%) from home gardens were collected. From the total species, 115 were reported to cure only human diseases, 10 species for livestock ailments and 30 for both. Asteraceae contributed 16 species and ranked first followed by Lamiaceae with 12 species. Frequently used plant parts were leaves (43.9%) and roots (31%). The recurrent mode of preparation was pounding (27.9%) followed by powdering (16%) and mostly administrated through oral drinking (33%) and dermal cream (15.7%). Paired comparison revealed that Cucurbita pepo was the most preferred species to treat headache. However, Olea europaea subsp. cuspidata was reported as the most multipurpose plant species. Priority ranking indicated that Lupinus albus was the rarest medicinal plant in the study area. The medicinal plant resources of the area were threatened by agricultural expansion, charcoal making, firewood collection and overgrazing. 
 
 Key words: Ethnobotany, indigenous knowledge, medicinal plants, Menz Gera Midir.


INTRODUCTION
Historically, relationship between plants and human are not only limited to the use of plants for food, clothing and shelter but also includes their use for religious ceremonies, ornamentation and healthcare (Schultes, 1992). Traditional people around the world acquire unique knowledge of plant resources on which they depend for food, medicine, cultural and religious practice (Martin, 1995). Ethnobotany is then the way of scientific investigation on the use of these plants in traditional culture for food, medicine, magic, rituals, building, Household utensils and implements, musical instruments, firewood, pesticides, clothing, shelter and other purposes (Urga et al., 2004).
Medicinal plants preferably have significant contributions in the healthcare scheme of local communities as the main resource of medicine for the mainstream of the rural population (Hailemariam et al., 2009). About 80% of the world's population relies chiefly on traditional medicine for their healthcare practices (Brown, 1992). This is because the traditional systems are culturally more acceptable and convene the psychological needs of people than modern medicine (Brown, 1992). Thus, medicinal plants are widely used for the treatment of numerous human and livestock aliments in different parts of the world.
Ethiopia has a long history of traditional medication and developed practices to treat diseases using diverse cultural systems found in the country (Shimeils et al., 2012). Healing in Ethiopian traditional medicine is not only concerned with curing of diseases but also with the protection and promotion of human physical, spiritual, social, mental and material wellbeing (Bishaw, 1991). It was widely believed in Ethiopia that the skill of traditional health practitioners is 'given by God' and knowledge on traditional medicines is passed orally from father to a favorite child, usually a son or is acquired by some spiritual procedures. Traditional healing knowledge is maintained by certain families or social groups (Gidaya et al., 2009), although needed to meet the goals of a wider coverage of primary healthcare delivery in all countries.
In Ethiopia, 80% of the population use traditional medicine due to the cultural acceptability of healers and local pharmacopeias, the relative low cost of herbal medicine and the limited access to modern health facilities (Deribe et al., 2006). In addition, there is cultural diversity and the use pattern of the various flora differ accordingly (Balemie et al., 2004). Although the medicinal plants were playing a key role for the development and advancement of modern drugs (Heinrich, 2000), both human and natural factors are heavily contributing to the loss of these plants and cause gradual displacement of associated indigenous knowledge.
Ethiopian people used to transfer indigenous knowledge about traditional medicinal plants mostly in a secret way from generation to generation orally. So then, there is a gap in the documentation and records about traditional knowledge on medicinal plants, even if they are serving as remedies for both human and livestock diseases. Whereas, the knowledge and use of plants is an integral part of many ethnic rural cultures in Ethiopia, the extent of which has not yet been studied in depth (Abbink, 1995). For instance, the ethnobotanical study in the people of Menz Gera Midir has remained unexplored and no documentation has been done on the medicinal plants and the associated knowledge available before this study.
Therefore, this study was conducted to document medicinal plants used by local people and the associated indigenous knowledge acquired regarding the methods to preparation, prioritize for use and the routes of administration in Menz Gera Midir District, Ethiopia.

Description of the study area
Menz Gera Midir is one of Districts found in North Shewa (Figure 1) in the Amhara Regional State. It is located 282 km Northeast of Addis Ababa, capital city of Ethiopia. The total area coverage is 116, 816 hectare comprising 20 kebeles (small administrative category next to District). The estimated population was 93,738 (47,994 female and 45, 744 male) and 99.56% of them are Orthodox Christianity followers belonging to the Amhara ethnic group and speaking Amharic as their native language. The elevation of study area ranges from 1680 to 3600 m. a. s. l. and lies between 10°5' to 100°32' N and 38° 28' to 38° 49' E. The soil types of the study area was 61.8% Brown, 18.2% Clay, 13% Red and 7% Gray, and has major agro-climatic zones described as WURCH (Afroalpine), DEGA (highland area) and WEINA-DEGA (middle altitude). Data obtained from the unpublished National Meteorological Service (NMSA) Agency showed that the annual rainfall was 888 mm and the distribution is bimodal and minimum and maximum temperatures was 8. 7°C and 20°C, respectively (NMSA, 2013). The vegetation of the area is dry evergreen Afromontane type characterized by the presence of major tree species that include Juniperus procera, Acacia abyssinica, Podocarpus falcatus, Olea europaea subsp. cuspidata, Hagenia abyssinica, Eucalyptus globulus and Afro-alpine type with most conspicuous giant lobelia (Lobelia rhynchopetalum) and sub-afroalpine ecosystem. The current land use in the study area was predominantly (85%) smallholder agriculture with an average landholding size of one hectare per household. The seed farming complex was a common practice where barely (Hordeum vulgare), wheat (Triticum spp.), faba bean (Vicia faba) and lentil (Lens culinaris) are the dominant crops. In addition, livestock rearing was also an integral part of the agricultural system in the study area.

Study sites and informant selection
In the Menz Gera Midir District, about 20 kebeles were found. Out of these, 12 kebeles were selected purposely through guidance of District's Tourism Office employees based on availability of traditional healers and plant species for the study. These kebeles are: AREGO, ATEDAS-GEDANBO, DERGAGN, GEYA, KELADUHA, KEWOSA, MESALE MARIAM, NEGASI AMBA, SHOLA, SRA GEDEL, TSEHAY SINA and WEZED. A total of 72 informants (47 male and 25 female) aged between 20-90 years (12 of them were key informant taking 1 from each kebele) were selected by the recommendation of elders and local authorities. Out of total informants, 38 completed grade 3-12 and the remaining 34 were illiterate. All informants (62 married, 5 divorced and 5 single) are Orthodox Christian Religion followers and native Amharic speakers.

Ethnobotanical data collection
The data were collected from November 2012 to January 2013 using ethnobotanical data collection techniques such as semistructured interview, group discussion and guided field walk. Informants were interviewed at least twice for same question to evaluate reliability of the information.

Data analysis
In this study, both qualitative and quantitative analytical tools were used for data analysis following approaches of Martin (1995) and Cotton (1996). The Informant Consensus Factor (ICF) was calculated for each disease category to identify the agreements of the informants on the reported cures for eight human disease categories. The ICF was calculated as follows: number of use citations in each category (Nur) minus the number of species used (Nt), divided by the numbers of use citations in each category minus one (Heinerich et al., 1998). Priority ranking were conducted by asking people to list plants that are becoming increasingly rare in their communal forests. Therefore, a set of eight medicinal plants were selected from the lists reported by most informants as scarce in the study area. Then, selected plants were presented to eight randomly selected key informants to rank them according to their degree of scarcity using numerical value (1, 2, 3, and so on). The most scarce medicinal plant species were given the highest value while abundant one was assigned a value of 1. Then, the numbers were summed and ranked. For the degree of informants herbal remedies preference to treat headache in the study area, paired comparison was done (Martin, 1995). For this purpose, eight key informants were randomly selected and allowed to show their responses independently for pairs of five medicinal plants that are noted for treating headache. All possible combinations were made and sequence of pairs and order within each pair was randomized before every pair was presented to selected informants. Their responses were recorded carefully and then the total values were summarized and ranked based on the informants report. Specificity for a certain disease was then also checked by fidelity level calculation (Friedman et al., 1986). The medicinal plants which have multipurpose nature for local people were checked using direct matrix ranking method. According to informants' indication, eight multipurpose plant species were selected for seven use diversities. Then eight key informants were asked to assign use values: 5= excellent, 4= very good, 3 = good, 2 = less used, 1 = least used, 0 = not used, for each species based on the multiple purpose. Finally, ethnobotanical data were entered in to excel spreadsheet and interpreted using tables, and descriptive statistics.

Taxonomic diversity of medicinal plants
A total of 155 medicinal plant species distributed in 133 genera and 65 families were collected, identified and documented (Appendix 1). From the total families, 61 (93.84%) were angiosperms, 2 (3.08%) gymnosperms and 2 (3.08%) were cryptograms. Among the angiosperms, the most dominant (92%) group were the dicotyledons, whereas 8% were monocotyledons. Asteraceae was found to be the most dominant family that contained 16 medicinal plant species under 13 genera followed by Lamiaceae, which had 12 species distributed in 10 genera. Out of the total collected medicinal plants, 13 species are endemic to Ethiopia and 5 species are placed under the near endemic category since they were found both in Ethiopia and Eritrea. Herbs constituted the largest category of medicinal plants (68; 43.9%) species followed by shrubs (47; 30.3%) in the study area.The natural vegetation of the study area was categorized visually into six major groups based on the dominance of the plant species: (1) The J. procera-dominated plant community type was predominantly found in three Kebeles (KEWOSA, MESALE MARIAM and SRA GEDEL) and around few churches at an altitudinal range of 2700-2930 m a.s.l. Under this, 4 species of medicinal plants were obtained; (2) The Lobelia rhynchopetalum-dominated community type was mainly dominated by a single species and found in DERGAGN Kebele, located at the mountain tops (3458 m a. s. l.); (3) The E. globulus-dominated community type was the plantation found in almost all parts of the study area. This species has been widely planted in the area as it is one of the good money generating species for the farmers in the locality. A. africanus and P. sphacelatum were common herbaceous medicinal plants found in this community; In the study area, traditional healers used different ways of medicinal plant remedy preparation. Among these principal methods, pounding ranked first (27.9%), followed by powdering (16%), and squeezing (15.3%) and cooking was the least (0.34%). The prepared remedies were mostly taken oral drinking (33%) followed by dermal application in the form of cream (15.7%) and eating (11.9%). Dosage was estimated using spoon, cup, cans, and glass for liquids, and for powders spoonful counting or in some cases handful (EFEIGN) was used. The dosage is mostly age and patient status dependent.

Human and livestock ailments treated by medicinal plants
In the present study, 83 ailments (68 in human, 6 in livestock and 9 in both humans and livestock) were reported to be treated by medicinal plants (Table2; Appendix 1). The informants also cite top commonly known medicinal plants in the study area using ranks and C. ficifolius were cited by 50 (69.44%) informants and ranked 1st, Artemisia abyssinica was cited by 49 (68.05%), and L. ocymifolia by 48 (66.66 %) ( Table 1).
The abundance and scarcity of medicinal plants in the study area was checked by preference ranking exercise conducted on eight species by eight key informants. The results showed that L. albus was the scarcest medicinal plant, cultivated only by limited number of individuals in their home garden who asserted that they get the seeds from around Bahir Dar (Table 3).
Moreover, paired comparison was also made to determine the most preferred medicinal plants among the five species that were used to treat headache in the study area. Traditional healers are well experienced to treat headache using different herbal medicine in the study area. Then, the paired comparison techniques were done to select the most promising medicinal plant form the others to treat it.
Thus, eight key informants participated in this activity and indicated that C. pepo was used more to treat headache followed by M. salicifolia (Table 4). Medicinal plants in the study area had also multiple uses for the community. Direct matrix ranking showed that O. europaea subsp. cuspidata ranked first due to the multipurpose role it has for the community and this was followed by E. globulus and J. procera (Table 5). The fidelity level of the data was calculated based on the diseases frequently reported by informants and traditional use of medicinal plant for treatments. The diseases include evil eye, "EYNEWOG", wound, eczema, stomach ache; eye disease, fibril illness and common cold which were confirmed to frequently occur in the area. Consequently, traditional healers employed their indigenous knowledge to manage these frequent diseases using selected medicinal plant species (Table 6). In Menz Gera Midir District, there are natural and human made factors that cause the threat on medicinal  Tool  30  32  33  35  36  38  19  33  Total  124  125  117  157  186  145  179  176  Rank  7th  6th  8th  4th  1st  5th  2nd  3rd plants. This study confirms that the most threatening factor for medicinal plants and the associated indigenous knowledge disappearance are anthropogenic factors such as deforestation and overexploitation of landscape for charcoal, fire wood, for construction overgrazing, and agricultural expansion. Informants ranked agricultural expansion as the most serious threat for medicinal plants followed by charcoal making (Table 7). Local people in the area have strong and actual belief on healing power of plants and they know their habitats, distribution, harvesting techniques, time of harvest and the status of a plant. The healers also know the site in which medicinal plants were found and the parts to be harvested. Plant apex, main root and regenerating parts are not harvested. This is to keep and increase the regeneration capacity of the plant. Therefore, the appropriate way of harvesting technique has direct or indirect contribution for the conservation of medicinal plants, since they limit excessive loss of these plants in one way or another. Furthermore, sites dominated by O. rochetiana and R. vulgaris plant community types and church forests were protected in SRA GEDEL Kebele. In these areas, medicinal plants are sheltered and conserved. On the other hand, it was also observed that the local farmers make use of their indigenous knowledge in protecting important plant species on their farm lands, home gardens, and as live fence. In some cases, few traditional healers cultivate very rare species in their home gardens like L. albus.

DISCUSSION
Menz Gera Midir District has relatively high taxonomic diversity in medicinal plants with 155 species reported under 133 genera and 65 families. Asteraceae was the family with the highest number of medicinal plants, which is largely a result of the abundance and wide distribution of members of the family in the flora of Ethiopia and Eritrea (Tadesse, 2004). It is also reported to be the family that encompasses large number of medicinal plant species along with the Lamiaceae and Fabaceae in the nearby Minjar-Shenkora District (Alemayehu et al., 2015).
In the study area, wild medicinal plant species were more dominant (104, 67.1%) and harvested from the natural vegetation. Similarly, ethnobotanical studies undertaken elsewhere in Ethiopia (Birhane et al., 2011;Yirga et al., 2011;Alemayehu et al., 2015;Meragiaw et al., 2016) have repeatedly shown that wild areas are primary sources of medicinal plants. In addition to this, farmlands and home gardens maintain a considerable number (51, 32.9 %) of species used in traditional herbal medicine. Informants during interview and group discussion categorized the medicinal plants of the area into common, medium and rare species. From the total medicinal plant species, 27.74% were recorded as rare, 29% as common and 42.26% as medium in the study  (Friedman et al., 1986;Addisie et al., 2012). This is due to the fact that herbs can grow everywhere and dominate during the wet seasons as compared to others such as trees, shrubs and woody climbers/lianas.
The current study confirmed that considerable number of medicinal plant species were collected and documented for treatment of human and livestock ailments. Out of the collected medicinal plants, more species were reported as being used to treat human diseases compared to medicinal plant species used for livestock ailments. Fewer numbers (6 of livestock diseases) and 10 medicinal plants were reported as compared to humans (68 diseases and 115 species). This showed that people of the study area are more conscious and give more attention for their ailments than the livestock diseases (Megersa et al., 2013).Traditional healers are dominantly using the leaves (43.9%) because of presence of high bioactive compounds which increase efficacy of remedies followed by roots (31%). This is consistent with other findings (Hailemariam et al., 2009;Chekole et al., 2015; Adefa and Abraha, 2011) elsewhere in Ethiopia.
On the contrary, the numbers found in some other parts of the country reported that roots are the most widely used plant parts for medicinal value (Birhane et al., 2011;Mesfin et al., 2009;Flatie et al., 2009). Most of the plant remedies are prepared by pounding (27.9%) followed by powdering (16%) which is positively supported by the finding of Getaneh and Girma (2014) in Deber Libanos District. However, squeezing came in the first place as a way of preparation in Mecha District (Chekole et al., 2015). The prepared remedies were efficiently used in fresh (43.22%) form followed by dried (31.61%) and either of the two (25.17%) to treat aliments. Different findings were also reported in consonance with this study (Meragiaw et al., 2016;Megersa et al., 2013;Yineger et al., 2008).
The routes of administration mostly depend on the nature of ailments to be treated. The most popular way of administration of traditional herbal/plant medicines are Thus, this is expected to cause risk due to under dose and over dose during treatment of patients. Then, lack of precision and standardization has been mentioned as drawbacks of traditional medication (Sofowora, 1982;Abebe, 1986;Araya et al., 2015). Sometimes traditional healers impose the restrictions when certain types of remedies are taken by patients. For instance, patients who take a remedy against impotency prepared from the root of M. ferruginea were instructed that their body parts should not touch water for 24 hours to increase efficacy of the remedy. Healers also advise patients to take additives like milk, coffee, tea, tela, butter and honey to improve medication efficacy and reduce the adverse effects of remedies during traditional medication.
The use of medicinal plants was calculated on frequently reported diseases with respect to medicinal plant species. The fidelity level of Capparis tomentosa and W. somnifera for evil eye and C. ficifolius for stomach ache was scored 100. Since these plant species are highly known by the healers and also have high efficacy to treat these diseases. Furthermore, there is no any modern drug that used to heal evil eye. Priority ranking confirmed the existence of some medicinal plants which are referred by local people at scarce situations. The scarcity is resulted because of anthropogenic and natural factors like deforestation for agricultural expansion, fire wood collection, fire, overgrazing and urbanization as major threats of medicinal plants in Ethiopia (Gebeyehu et al., 2014;Getaneh and Girma, 2014;Alemayehu et al., 2015;Kewessa et al., 2015;Chekole et al., 2015).
In the area, informants reported that several medicinal plants have already disappeared from their common habitats and some of them are at risk of extinction. The first factors for the declining of medicinal plants were agricultural expansion followed by charcoal making in the study area. Other reports (Mesfin et al., 2009;Meragiaw et al., 2016) indicated that agricultural expansion was the major threat on medicinal plants both in Wonago and Northwestern Wello districts. In most situations, the home gardens maintain threatened medicinal plants by protecting from grazing and unwise harvesting. This is a good opportunity for wise use and better transfer of the indigenous knowledge to the younger generation. However, in-situ conservation in the natural environment is the best recommended method to save important medicinal plant species for keeping them in their natural condition.

Conclusion
The results of this study indicated that the potential and abundance of medicinal plant species (155) in the Menz Gera Midir District is an important resource for the present and future generations.
The higher proportion (74%) of these plants was used to treat human ailments further indicates the important role that the medicinal flora has for the healthcare of the immediate society and others. The number of human and livestock ailments (83 diseases) treated with medicinal plants also indicates how important these plants are to the society in Menz Gera Midir District.
From this, we can conclude that the community in this area was achieving alternative relief of diseases if the modern therapy is lacking. The natural vegetation in Menz Gera Midir is rich in medicinal plants (104 species) although a good number of species (51species) were available in the home gardens. The results also showed that herbs are the leading remedies in the area while shrubs and trees also had their contributions.
The traditional healers revealed that the leaves are the most frequently used plant parts with roots having their shares to prepare mostly in fresh condition and predominantly administered through oral route. Traditional healers' indigenous knowledge has variation among age and gender in which elders and men are solely shelve their knowledge on herbal medicine and transfer through strict secret. However, modern education is partially contributing to the undermining of traditional knowledge acquisition in younger generation.
The results further showed that many wild medicinal plant species are under threat by the various natural and human factors sending signals for the attention needed to conserve these medicinal plants.

CONFLICT OF INTEREST
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. study. The deepest gratitude was forward to Late Prof. Ensermu Kelbessa for his unlimited contribution on species identification, conformation and several round editing of this paper. Appreciation also goes to the people of Menz Gera Midir, particularly the informants and employees of district offices, for their hospitability and kind help.