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Exploration of challenges in bringing traditional medicine into SA’s healthcare system, using medicinal plants for treatment of waterborne diarrhoeal diseases as a case study

Strategies to facilitate collaboration between allopathic and traditional health practitioners

  • Authors: Tembani, Nomazwi Maudline
  • Date: 2009
  • Subjects: Alternative medicine -- South Africa , Healers -- South Africa , Physicians -- South Africa
  • Language: English
  • Type: Thesis , Doctoral , DCur
  • Identifier: vital:10012 , http://hdl.handle.net/10948/1283 , Alternative medicine -- South Africa , Healers -- South Africa , Physicians -- South Africa
  • Description: The formal recognition of traditional healing has been controversial for some time with traditional healers being labelled by those of conventional medical orientation as a medical hazard and purveyors of superstition. The support for the development of traditional medicine and establishment of co-operation between traditional healers and allopathic heath practitioners was first promoted in the international health arena by the World Health Organisation. Estimating that 80% of the population living in rural areas of many developing countries was using traditional medicine for the primary healthcare needs, this organisation advocated for the establishment of mechanisms that would facilitate strong cooperation between traditional healers, scientists and clinicians. The study was undertaken in the Amathole District Municipality, Province of the Eastern Cape based on Chapter 2, Section 6(2) (a) of the Traditional Health Practitioners Bill 2003, which required regulation and promotion of liaison between traditional health practitioners and other health professionals registered under any law. The purpose of the study was to develop and propose strategies to facilitate collaboration between traditional and allopathic health practitioners to optimise and complement healthcare delivery. The conceptual framework guiding the study was derived from Leininger’s theory of Cultural Care Diversity and Universality chosen because of its appropriateness. The terms used throughout the study were defined to facilitate the reader’s understanding. Ethical principles were adhered to throughout the research process. To ensure trustworthiness of the study, Guba’s model (in Krefting,1991:214-215) was used where the four aspects of trustworthiness namely, truth value, applicability, consistency and neutrality were considered. A qualitative, exploratory, descriptive and contextual research design was used which assisted in articulating the appropriate strategies to develop to facilitate v collaboration between allopathic and traditional health practitioners. The study was done in two phases. Phase one entailed data collection using unstructured interviews, a focus group interview, literature control and modified participant observation. In Phase two strategies to facilitate collaboration between allopathic and traditional health practitioners were developed. The population in this study comprised three groups of participants. Group 1 consisted of allopathic health practitioners, Group 2 comprised traditional healers and Group 3 was composed of participants who were trained as both traditional healers and allopathic health practitioners. All participants had to respond to three research questions which aimed at:  exploring and describing the nature of the relationship between allopathic and traditional health practitioners before legalisation of traditional healing and their experience as role-players in the healthcare delivery landscape in the Amathole District Municipality.  eliciting the viewpoints of allopathic and traditional health practitioners regarding the impact on their practices of legalisation of traditional healing and  developing strategies to facilitate collaboration between allopathic and traditional health practitioners. Data obtained from each group was analysed using Tesch’s method as described by Creswell (2003:192). Themes emerging from data and the corresponding strategies to address the themes were identified for each group. The participants’ responses to the three research questions revealed areas of convergence and divergence. Of significance was the reflection by the participants on their negative attitude towards each other. They also highlighted that there was no formal interaction between traditional and allopathic health practitioners in the Amathole District Municipality. Their working relationship was characterised by a one-sided referral system with traditional healers referring patients to allopathic health practitioners but this seemed not to be reciprocated vi by the latter group. The exception was the case of traditional surgeons whose working relationship with allopathic health practitioners was formally outlined in the Application of Health Standards in the Traditional Circumcision Act, Act No.6 of 2001. Allopathic health practitioners attributed their negative attitude as emanating from the unscientific methods used by traditional healers in treating patients, interference of traditional healers with the efficacy of hospital treatments and delays by traditional healers in referring patients to the hospitals and clinics. Traditional healers stated that they were concerned about failure of allopathic health practitioners to refer patients who talked about “thikoloshe” and “mafufunyana” to the traditional healers. Consequently, these patients presented themselves to the traditional healers when the illness was at an advanced stage. A reciprocal referral system was perceived by the traditional healers as the core element or crux of collaboration. There were ambivalent views regarding the impact of legalisation of traditional healing on the practices of both traditional and allopathic health practitioners. Elimination of unscrupulous healers, economic benefits, and occupational protection were benefits anticipated by traditional healers from the implementation of the Act. The possibility of having to divulge information regarding their traditional medicines, monitoring of their practice resulting in arrests should errors occur were however, cited by traditional healers as threatening elements of the Act. A lack of understanding the activities of each group with an inherent element of mistrust became evident from the participants’ responses. Ways of fostering mutual understanding between them were suggested which included holding meetings together to discuss issues relating to healing of patients, exposing both groups of health practitioners to research, as well as training and development activities. The participants also highlighted areas of collaboration as sharing resources namely, budget, physical facilities, equipment and information and role clarification especially pertaining to disease management. The participants vii strongly suggested that there should be clarity on the type of diseases to be handled by each group. The need for capacity building of traditional and allopathic health practitioners in preparation for facilitating collaboration was advocated by all and the relevant activities to engage into were suggested. Analysis, synthesis and cross referencing of the themes that emerged from the data culminated in the identification of three strategies that were applicable to all groups of participants and which would assist in facilitating collaboration between allopathic and traditional health practitioners. The researcher coined the three strategies “Triple C” strategies abbreviated as the TRIC strategies. The first “C” of the three “Cs” stands for “change attitude”, the second “C” for “communication” and the third “C” for “capacity building.” Each of the proposed three strategies is discussed under the following headings:- Summary of findings informing the strategy  Theory articulating the strategy  Aim of the strategy  Suggested implementation mechanism As the strategies had to be grounded in a theory which would serve as a reference point, the researcher used the Survey List by Dickoff, James and Wiedenbach (1968:423) as a conceptual framework on which to base the proposed three strategies. The results of this study and recommendations that have been made will be disseminated in professional journals, research conferences and seminars.
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  • Date Issued: 2009

Three perspectives on ukuthwasa: the view from traditional beliefs, western psychiatry and transpersonal psychology

  • Authors: Booi, Beauty Ntombizanele
  • Date: 2005
  • Subjects: Healers -- South Africa , Divination -- South Africa , Schizophrenia -- Social aspects , Xhosa (African people) -- Psychology , Xhosa (African people) -- Social life and customs
  • Language: English
  • Type: Thesis , Masters , MA
  • Identifier: vital:2936 , http://hdl.handle.net/10962/d1002445 , Healers -- South Africa , Divination -- South Africa , Schizophrenia -- Social aspects , Xhosa (African people) -- Psychology , Xhosa (African people) -- Social life and customs
  • Description: Among the Xhosas, the healing sickness called intwaso is interptreted as a call by the ancestors to become a healer. Transpersonalists also see these initiatory illnesses as spiritual crises, while according to the widely accepted Western psychiatric view, illness is purely perceived in physical and psychological terms. A case study was conducted where a single participant who has undergone the process of ukuthwasa and is functioning as a traditional healer was interviewed. A series of interviews were done where information was gathered about significant experiences related to ukuthwasa process. Tapes were transcribed and a case narrative was written and interpreted using the traditional Xhosa beliefs, the western psychiatric and the transpersonal psychology perspectives. Strengths and weaknesses of each perspective were then examined.
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  • Date Issued: 2005

Healing at the margins: discourses of culture and illness in psychiatrists', psychologists' and indigenous healers' talk about collaboration

  • Authors: Yen, Jeffery
  • Date: 2000
  • Subjects: Traditional medicine -- South Africa , Medical policy -- South Africa , Mental health -- South Africa , Healers -- South Africa
  • Language: English
  • Type: Thesis , Masters , MA
  • Identifier: vital:3090 , http://hdl.handle.net/10962/d1002600 , Traditional medicine -- South Africa , Medical policy -- South Africa , Mental health -- South Africa , Healers -- South Africa
  • Description: This dissertation explores discourses about culture and illness in the talk of mental health professionals and indigenous healers. It represents an attempt to situate the issue of indigenous healing in South Africa within a particular strand of critical discourse analytic research. In the context of current deliberations on the value, or otherwise, of indigenous healing in a changing health and specifically mental health system, the talk of both mental health practitioners and indigenous healers as they conceptualise “disorder”, and discuss possibilities for collaboration, is chosen as a specific focus for this study. Disputes over what constitutes “disorder” both within mental health, and between mental health and indigenous healing are an important site in which the negotiation of power relations between mental health professionals and indigenous healers is played out. The results of this study suggest that despite the construction of cogent commendations for the inclusion of indigenous healing in mental health, it remains largely marginalised within talk about mental health practice. While this study reproduces to some extent the marginalisation of indigenous healing discourse, it also examines some of the discursive practices and methodological difficulties implicated in its marginalisation. However, in the context of “cultural pride strategies” associated with talk about an African Renaissance, indigenous healing may also function as a site of assertion of African power and resistance in its construction as an essentially African enterprise. At the same time, it may achieve disciplinary effects consonant with cultural pride strategies, in constructing afflictions in terms of neglect of, or disloyalty to cultural tradition. These results are discussed in terms of the methodological difficulties associated with interviewing and discourse analysis of translated texts, which contributes to difficulties with articulating indigenous healing discourse in a way that challenges the dominant psychiatric discourses implicated in its marginalisation within mental health. It concludes with recommendations for future research which addresses indigenous healing discourse in its own terms, and examines its operation as a disciplinary apparatus in South African society.
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  • Date Issued: 2000

Social change and shifting paradigms: the choice of healer among black South Africans in psychological counselling

  • Authors: Johnson, Alexandra Blythe
  • Date: 2000
  • Subjects: Healers -- South Africa , Psychotherapy Cross-cultural studies , Xhosa (African people) -- Psychology
  • Language: English
  • Type: Thesis , Masters , MA
  • Identifier: vital:2998 , http://hdl.handle.net/10962/d1002507 , Healers -- South Africa , Psychotherapy Cross-cultural studies , Xhosa (African people) -- Psychology
  • Description: Social change in South Africa brings to light the multiplicity of world-views operating in our society, which individuals encountering a variety of social contexts are faced with. This raises questions about the choices black South Africans face in response to influences from Western and traditional African culture. This issue was approached through examining helpseeking choices made between different health care sectors that stem from different world-views. This would indicate whether individuals are drawing on a variety of belief systems. The sources of their beliefs are put into context by looking at the communities of practice that influence their local knowledge. Help-seeking is also influenced by the identities the individual may ascribe to, which are derived from the multiple positions held by them in different social contexts. In this research the use of health-care sectors by four black women attending psychotherapy is examined. Their use of these sectors reflects a potential multiplicity of world views. Semistructured interviews were conducted, focusing on participants' prior experience of different help options, and their current perceptions of traditional African healing and psychology. The texts were analysed using a qualitative hermeneutic method, the reading guide. Data was looked at through three main themes, the individual's relationship to the health care sectors, their knowledge of different world views, and the identities they adopted which may be influential in their choice of a healer. It was found that in two participants there was some movement away from traditional beliefs, with one rejecting the traditional healers who did not help her, once she has discovered therapy, and another identifying herself completely with Western medicine. In contrast, one participant illustrated a rediscovery of traditional healing, whilst still attending psychotherapy. This suggests that shifts in knowledge are not necessarily away from traditional beliefs. It was also found that the two participants who had experienced a broader variety of social contexts and identified with multiple belief systems, tended to use a variety of Western and traditional healing sources and selected the healing option they felt was most appropriate to a particular problem. It is argued therefore that having a variety of knowledge and beliefs places individuals in a more powerful position to determine their choice of action than those with a limited range of knowledge.
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  • Date Issued: 2000

The healer's art : Cape Nguni diviners in the townships of Grahamstown

  • Authors: Hirst, Manton Myatt
  • Date: 1991
  • Subjects: Healers -- South Africa , Nguni (African people) -- Social life and customs , Divination -- South Africa , Medicine, Magic, mystic, and spagiric -- South Africa , Nguni (African people) -- Religion
  • Language: English
  • Type: text , Thesis , Doctoral , PhD
  • Identifier: vital:2084 , http://hdl.handle.net/10962/d1001601
  • Description: This is a study of Cape Nguni diviners practising in the townships of Grahamstown where, during the 1970s, there was a large and active concentration of diviners treating clients from the locality, the rural areas and even the large urban centres further afield. The study situates local diviners in the socio-economic, cultural and religious context of contemporary township Iife during the 1970s (see chapter 1 and section 2.1). The personalities and socio-economic circumstances of diviners (and herbalists) are described as well as their case-loads, the various problems they treat, the relations between them and their clients, the economics of healing and the ethics pertaining to the profession (see chapter 2) . Chapter three focuses on the various problems and afflictions - which are largely of an interpersonal nature - suffered by those who are eventually inducted as diviners and the ritual therapy this necessarily entails. Here we see how the diviner, what Lewis (1971) terms a 'wounded healer', becomes an expert in interpersonal and social relations as a result of suffering problems - largely connected to the family but not necessarily limited to it - in interpersonal relations and that require a ritual, and thus social, prophylaxis. The main theoretical argument is that the diviner, qua healer, functions as a hybrid of Levi-Strauss' s bricoleur and Castaneda's 'man of knowledge' artfully combining the ability of the former to invert, mirror or utilise analogies from linguistics to make everything meaningful and the ability of the latter to creatively bend reality . The diviner's cosmology is described in terms of a 'handy', limited but extensive cultural code/repertoire of signs, symbols and metaphors that is utilised in getting the message across to others and in which animals bear the main symbolic load (see chapter 4). This leads logically to a reappraisal of Hammond-Tooke's (1975b) well-known model of Cape Nguni symbolic structure particularly in so far as it pertains to the way in which diviners classify animals, both wild and domestic (see section 4.6). A striking evocation and confirmation of the view argued here, namely of the diviner as bricoleur/'man of knowledge', is contained in chapter five dealing with an analysis of the diviner's 'river' myth and the context, form and content of the divinatory consultation itself. Finally, the conclusions, arising out of this study of contemporary Cape Nguni diviners in town, are evaluated in the ligrht of Lewis's (1966, 1971, 1986) deprivation hypothesis of spirit possession (see chapter 6)
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  • Date Issued: 1991

Psycho-diagnostics in a Xhosa Zionist church

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