Doctor urges regulation of traditional bone setters as road crash toll rises
A Nigerian medical practitioner has called on government authorities to urgently regulate traditional bone setters (TBS), warning that the absence of oversight is worsening injury outcomes amid Nigeria’s growing road
A Nigerian medical practitioner has called on government authorities to urgently regulate traditional bone setters (TBS), warning that the absence of oversight is worsening injury outcomes amid Nigeria’s growing road traffic trauma burden.
Dr. Festus Babarinde, a 2025 Martin Luther King Community Service Award winner and 2020 NYSC Presidential Award recipient, made the appeal against the backdrop of fresh data from the Federal Road Safety Corps (FRSC), which indicates that Nigeria recorded 10,446 road crashes in 2025—representing a 9.2 per cent increase compared to the previous year.
According to him, the rising crash figures are not only a public safety concern but also a reflection of deeper systemic weaknesses in emergency and trauma care delivery across the country. Dr. Babarinde noted that despite the scale of road traffic injuries, a significant proportion of victims do not first present at formal health facilities. He said as many as 85 per cent of fracture cases in Nigeria reportedly consult traditional bone setters before seeking hospital-based care, a trend he attributed to gaps in accessibility, affordability, and public trust in the formal health system.
“Hospitals are often expensive, distant, and perceived as impersonal,” he said, adding that traditional bone setters, by contrast, are more accessible, culturally familiar, and deeply embedded within community trust networks. Their services, he noted, are frequently reinforced by family influence and long-standing social acceptance.
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Traditional bone setters typically rely on manual bone manipulation techniques and herbal preparations, practices passed down through generations. While widely utilised, Dr. Babarinde referenced global estimates, including those from the World Health Organisation, which suggest that between 10 and 40 per cent of dislocation cases in some settings are managed by similar informal practitioners—highlighting a persistent gap in formal orthopaedic access.
However, he warned that early reliance on traditional bone setters often leads to avoidable complications. Orthopaedic units across Nigeria, he said, frequently receive patients only after conditions have worsened significantly, including infected fractures, compartment syndrome, malunions, and gangrene. “In many cases, what could have been a straightforward fracture management case becomes limb-threatening or even fatal due to delayed presentation and inappropriate handling,” he explained.
He stressed that such outcomes are not solely clinical failures but reflect broader systemic challenges. “These are consequences of gaps in access, trust, and coordination within our healthcare system,” he said. Dr. Babarinde further argued that the unregulated nature of traditional bone setting practice—where individuals can operate without formal certification or standardised training—poses a significant public health risk, particularly in trauma care.
He proposed a framework for integration rather than exclusion of traditional practitioners, outlining three key interventions. First, he recommended structured training programmes for bone setters, focusing on basic hygiene practices, safe immobilisation techniques, early identification of complications, and timely referral protocols. Second, he advocated for regulatory oversight that would formalise practice standards, including certification requirements and monitoring systems to ensure accountability and patient safety. Third, he called for the establishment of clear referral pathways between traditional bone setters and orthodox medical facilities, enabling seamless transfer of high-risk cases to hospitals where specialised care is available.
Nigeria continues to face a heavy road traffic injury burden, with fatalities estimated to exceed 39,000 annually, according to road safety data. Dr. Babarinde warned that without coordinated reforms, the intersection between trauma incidence and informal treatment practices will continue to strain the health system and worsen preventable disability rates. “The objective is not to abolish traditional practice,” he said. “It is to ensure that wherever patients first seek care, they are not exposed to avoidable harm, but instead have access to safe pathways that improve their chances of recovery and survival.”
