Traditional healers, traditional hospitals and HIV / AIDS: a case study in KwaZulu-Natal.
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Acquired Immunodeficiency Syndrome↗
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Infertility and other fertility related issues in the practice of traditional healers and Christian religious healers in south western Nigeria.
Traditional healers have been an established source of health care delivery in Africa for centuries while Christian religious healers (193 traditional healers and 99 Christian religious healers) with respect to infertility and some other fertility-related issues. The findings show that both types of healers believe that infertility is most commonly due to the past life of the woman, physical problems related to the womb or to male potency, and imcompatibity between the man and the woman. Traditional healers also believed that being bewitched or being cursed can lead to infertility. Both groups of healers threat infertility by sacrifices, prayer and fasting, and timing of intercourse to coincide with the fertile period. Also 61% of traditional healers and 87% of religious healers advice their-clients with infertility to do nothing at least initially. To those clients seeking advice on preventing pregnancy, traditional healers tend to recommend herbal concoctions, beads and rings while Christian healers tended to recommend condoms, withdrawal method and the safe period. Both groups are consulted on premarital sex, premarital conception, sex during pregnancy and influencing the sex of an unborn baby. It was concluded that both traditional healers and Christian faith healers are involved with infertility and other fertility-related issues in their practices. There is an overlap in beliefs about causes and treatment of such conditions among both groups although areas of differences in beliefs and practices are clearly identifiable.
Adult↗
Complications of the 'treatment' of tonsillar infection by traditional healers in Nigeria.
Traditional healers in Nigeria attempt to treat tonsillar infections either by performing uvulectomy with a sickle knife or by digital rupture of the tonsil. These procedures result in various complications, including haemorrhage, septicaemia, cellulitis of the neck, peritonsillar and parapharyngeal abscess, upper airway obstruction, and pharyngo-laryngocele with pneumothorax. These complications are illustrated with case reports. The danger of encouraging traditional healers to practise unsupervised and unscientific medicine is stressed.
Adolescent↗
Characteristics of visitors to traditional healers in central Sudan.
Traditional healing is widespread in Sudan and traditional healers are well respected by the community. This study aimed to assess the characteristics of visitors attending traditional healers, the reasons for visits, the frequency of visits, satisfaction with visits and advantages and disadvantages of visits. The results showed that children under ten years did not take part in visits; most of the visitors were between 21 and 40 years (61%) and were women (62%). Visitors were less educated compared to the general population in the area. The main reasons given for attending traditional healers were treatment (60%) and blessing (26%). Visitors did not mention any disadvantages to visiting traditional healers.
Adult↗
The role of traditional healers in HIV / AIDS counselling in Kampala, Uganda. Key issues and debates: traditional healers.
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Acquired Immunodeficiency Syndrome↗
The patient relationship and therapeutic techniques of the South Sotho traditional healer.
Until 1996 the practice of traditional healers was outlawed in South Africa and not afforded a legal position in the community of health care providers. In 1978 the World Health Organization (WHO) identified traditional healers as those people forming an essential core of primary health care workers for rural people in the Third World Countries. However in 1994 the new South African government identified traditional healers as forming an essential element of primary health care workers. It is estimated that 80% of the black population uses traditional medicine because it is deeply rooted in their culture, which is linked to their religion. The traditional healer shares with the patient a world view which is completely alien to biomedical personnel. Therapeutic techniques typically used in traditional healing conflict with the therapeutic techniques used in biomedicine. The patients' perceptions of traditional healing, their needs and expectations, may be the driving force behind their continuous persistence to consult a traditional healer, even after these patients may have sought the therapeutic techniques of biomedical personnel. The operation of both systems in the same society creates a problem to both providers and recipients of health care. Confusion then arises and the consumer consequently chooses the services closer to her. The researcher aimed at investigating the characteristics of the relationship between the traditional healers and the patients, explored the therapeutic techniques that are used in the South Sotho traditional healing process, and investigated the views of both the traditional healers and the patients about the South -Sotho traditional healing process, to facilitate incorporation of the traditional healers in the National Health Care Delivery System. A qualitative research design was followed. Participants were identified by means of a non-probable, purposive voluntary sample. Data was collected by means of a video camera and semi-structured interviews with the six traditional healers and twelve patients, as well as by taking field notes after each session. Data analysis was achieved by means of using a checklist for the video recordings, and decoding was done for the interviews. A co-coder and the researcher analysed the data independently, after which three consensus discussions took place to finalise the analysed data. The researcher made conclusions, identified shortcomings, and made recommendations for application to nursing education, nursing research and nursing practice. The recommendations for nursing are reflected in the form of guidelines for the incorporation of the traditional healers in the National Health Care Delivery System.
Adult↗
Health care seeking behaviour and utilisation of traditional healers in Kalabo, Zambia.
OBJECTIVE: To identify traditional healers in the catchment area of Kalabo District Hospital and to investigate determinants which play a role in the choice between different health care options, and to explore possibilities for increasing co-operation between the District Hospital and traditional healers. METHODS: In a cross-sectional comparative and descriptive study, a combination of both quantitative and qualitative methods was used. A total of 12 health workers, 13 traditional healers and 100 community representatives were interviewed, using (semi)-structured questionnaires. A focus group discussion was held with 12 traditional healers. RESULTS: This study shows that all respondents are willing to visit the hospital if they fall ill in future, and 88% of the respondents will visit a traditional healer. More women than men visit traditional healers, but the men who do visit them, do so more frequently. Level of education is not an important determinant. Increasing age leads to more frequent visits to both the hospital and traditional healers. Almost half of the respondents (49%) only have to walk less than 30 min to a traditional healer, but the hospital is the same distance for only 34% of the respondents. Waiting time turned out to be an important factor: in the hospital, 48% of the respondents are not helped within time, and only 28% are not helped in time by the traditional healer. Demon possession, mbaci, kanono and infertility are typical health problems for which people visit a traditional healer. The cost of treatment from a traditional healer is usually one cow, but only if the patient is cured. Satisfaction was measured at 89% after hospital treatment, and 74% after treatment from a traditional healer. If dissatisfied with the traditional healer, 86% would consider attending the hospital.
Focus Groups↗
The role of the African traditional healer in women's health.
Traditional healers provide an important link between the rural people of Africa and primary health care. The purpose of this article is to review more recent literature and contemporary practices related to the role of the traditional healer in Africa and the move toward collaboration with an introduction of Western-style medicine and health care, especially for women. African women, particularly older ones in rural communities, utilize the traditional healer's timeless and ancient caregiving when faced with symptoms of mental and physical illness. The concept of training traditional healers and medical personnel to deliver traditional and Western health care to communities requires further consideration and a plan of implementation.
Africa↗
African traditional healers: what health care professionals need to know.
Traditional healing has always been a component of health care. In South Africa, traditional healers can obtain licences to practise but very little groundwork has been done to integrate Westernized medicine with traditional healing. The actual contribution of traditional healers to health care in the province of Kwa-Zulu Natal or South Africa is not known. This study determined the role of traditional healers in Durban, Kwa-Zulu Natal, the number of patients who consulted traditional healers, the types of conditions treated and the frequency of consultations. The opinions about physiotherapy of the patients who frequently consult traditional healers were also explored. Data were collected from 30 traditional healers and their 300 patients by means of questionnaires and interviews. The results show 70% of the patients would consult traditional healers as a first choice. Sangomas were the most popular type of healers and had as many as 20 patients per day. A significantly large number of patients consulted traditional healers for potentially life-threatening conditions. The patients knew very little or nothing about physiotherapy. We conclude that traditional healing is an integral component of health care in South Africa. Health care professionals need to be proactive in integrating traditional healing with Westernized practices to promote health for all.
Adult↗
Traditional healers and pulmonary tuberculosis in Malawi.
SETTING: Queen Elizabeth Central Hospital (QECH) and Blantyre district, Malawi. OBJECTIVE: To investigate the use that tuberculosis (TB) patients in Malawi make of traditional healers and traditional medicine. DESIGN: A questionnaire study was carried out on 89 smear-positive pulmonary TB patients admitted to QECH. Seven traditional healers in Blantyre were also interviewed about their knowledge, attitudes and practice of patients whom they considered to have TB. RESULTS: Of the 89 patients, 33 (37%) visited a traditional healer before seeking regular medical care. Patients spent a median length of 4 weeks with the traditional healer. During this time, 24 patients did not improve or deteriorated while on traditional treatment. No patient was referred to the medical services by the traditional healer. All traditional healers claimed to know about TB. Four said they would refer a patient to hospital if their treatment was not curative. In 1995, six traditional healers claimed to have cured 116 patients with TB. CONCLUSION: It is important to involve traditional healers in the educational activities of the National TB Control Programme. These healers need to be taught to recognise and refer patients with TB, whom they should not treat, but at the same time be encouraged to administer safe treatments for conditions which are more amenable to their practice.
Adult↗
Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania.
BACKGROUND: Traditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services. AIMS: To determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam. METHOD: The Clinical Interview Schedule-Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 from THCs, aged 16-65 years. RESULTS: The prevalence of common mental disorders among THC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated with THC attendance. None of these factors explained the excess of mental disorder among THC attenders. CONCLUSIONS: The high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.
Adolescent↗
STD/HIV/AIDS knowledge, beliefs and practices of traditional healers in Botswana.
The study investigated knowledge, beliefs, practices and experiences of traditional healers in relation to sexually transmitted diseases (STDs), HIV and AIDS. Traditional healers see about 70% of the African patients, with all kinds of ailments. The advent of HIV/AIDS and the introduction of home-based care in most African countries has increased the case-load of many traditional healers and increased the risk of contact with people living with HIV/AIDS. To protect themselves and their clients they need the right information on HIV/AIDS. Most traditional healers use their bare hands as a diagnostic tool and to apply topical medicine. Many traditional healers also utilize their mouths to suck blood from their patient's body as part of disease management. Most of the patients who are discharged from hospitals on home-based care usually end up at the traditional healer as relatives seek a second opinion or simply because they disagree with the diagnosis of incurable disease. This exposes traditional healers to HIV/AIDS. The study showed that traditional healers have some practices and beliefs, such as the use of the mouth for sucking blood (blood-letting), use of sharp instruments which is risky behaviour and the belief that HIV/AIDS is not a new disease. Further most of the traditional healers did not have adequate and in some cases correct information on HIV/AIDS. A few even believed they could cure AIDS as it has always been a disease they have been dealing with and were adamant it is not a new disease. Rapport between traditional healers and scientific medical personnel is essential for an effective and successful HIV/AIDS prevention and control programme.
Acquired Immunodeficiency Syndrome↗
A controlled study of an HIV/AIDS/STI/TB intervention with traditional healers in KwaZulu-Natal, South Africa.
Traditional healers play an important role in southern Africa culture and health care including the HIV epidemic. Here we report among the first controlled studies of an HIV/AIDS, sexually transmitted infections (STI) and tuberculosis (TB) intervention for traditional healers in South Africa. At baseline 233 traditional healers were assessed in four selected communities in the KwaZulu-Natal province and received either an experimental intervention or a no intervention control condition. The intervention group received training in HIV/AIDS, STI, and TB prevention over 3.5 days as well as a supervisory follow-up visit. At 7-9 months follow-up intervention effects were significant for HIV knowledge and HIV and STI management strategies including conducting risk behavior assessments and counseling, condom distribution, community HIV/AIDS and STI education, and record keeping. The study found a high level of preparedness among traditional healers to work with and refer patients to biomedical health practitioners, yet no higher levels of referral to biomedical practitioners were found after the training.
Acquired Immunodeficiency Syndrome↗
The challenges of involving traditional healers in HIV/AIDS care.
In sub-Saharan Africa, traditional healers play a major role in providing for the needs of people, particularly in rural areas where western health care is unavailable. Despite a paucity of reliable figures to determine the prevalence of traditional medicine usage, it is estimated that some 70% of sub-Saharan Africans access traditional healers. There is now mounting evidence of the importance of involving traditional healers in the management of the HIV/AIDS epidemic--both for their potential benefits, although poorly researched and understood, and to reduce the impact that some traditional healing interventions may play on the spread of HIV/AIDS and unsafe treatment of infected patients. While there are few collaborative projects between traditional healers and biomedical health providers, there is an enthusiasm on the part of traditional healers to collaborate and learn from their western-trained counterparts. Collaboration is essential, given the changing epidemic of HIV and the dynamic relationship between the two health sectors.
Africa South of the Sahara↗
Caring for people with HIV in Zambia: are traditional healers and formal health workers willing to work together?
This study of traditional healers and formal health workers determined their knowledge and practices in the field of HIV/AIDS and examined their training needs and attitudes to collaboration, in preparation for planning joint training workshops. Several misconceptions concerning symptoms and transmission of HIV disease were found in both groups, particularly among traditional healers. Twenty healers (51%) and four formal health workers (15%) claimed a cure existed for AIDS. The majority of traditional healers interviewed expressed difficulties discussing a diagnosis of HIV directly with patients, mainly due to fear of the patient becoming depressed and suicidal. Most interviewees wanted more training--the majority of traditional healers in recognizing symptoms of HIV/AIDS and their treatment, and the majority of formal health workers in HIV counselling. Most were interested in supplying condoms. Almost all healers and half of the formal health workers were keen to collaborate in training and patient care. The study indicates that there is willingness amongst Zambian traditional healers and formal health workers to collaborate in training and patient care in the field of HIV/AIDS. As well as covering symptoms, transmission and prevention of HIV/AIDS, training should aim to increase ability to openly discuss HIV with patients, which many traditional healers and some formal health workers find difficult. Involving traditional healers in supplying condoms may improve acceptability and availability, particularly in rural areas.
Acquired Immunodeficiency Syndrome↗
Traditional healers in Tanzania: sociocultural profile and three short portraits.
Traditional healers are an important part of African societies, but unfortunately the knowledge of the extent and character of traditional healing and the people involved in the practice is limited and impressionistic. They are frequently ignored in studies of user/provider patterns, although they cover the health needs of a substantial proportion of the population. For future health planning it is necessary to know what the reasons are that even in big cities, where western health care services are available, traditional healers flourish, and even compete with each other for certain aspects. The aim of this study was to investigate certain aspects of the profession of traditional healing in general in different areas in Tanzania in order to get an idea about the kind of traditional medical services which are available, and about the people who provide such services. For this reason traditional healers were interviewed with a semi-structured questionnaire in different rural and urban places: in the Kilombero valley (Kilombero/Ulanga district), on the main island of Ukerewe (Ukerewe District), and in the region near Bukoba town (Bukoba District), and in the settlement of Dar es Salaam (largest city of Tanzania). The results of the study show that traditional healers are a very heterogeneous group of persons not having much in common relating to their religion, sex and level of education. The traditional practice is very often taken over from a family member, but also other reasons for becoming a healer, like initiation through ancestor spirits, are very frequently given. More than 50% of the respondents practice full time. These full time practitioners are mainly found among men and in the younger age group. Treatment of in-patients, who can stay in special patient-houses, is offered by half of the traditional healers. Divination used as a diagnostic tool was found mainly among men. Referral of patients to the hospital was mentioned by almost all respondents in cases where they failed with their own treatment or when they knew that the patient would be better treated in the hospital or dispensary.
Adult↗
Changing patterns of corneal disease and associated vision loss at a rural African hospital following a training programme for traditional healers.
AIMS/BACKGROUND: Use of African traditional eye medicines (TEM) is associated with the presence of corneal disease, delay in presentation, and vision loss. An interactive training programme was conducted with traditional healers in Chikwawa District, Malawi and changes in the pattern of corneal disease assessed in patients presenting to the district hospital after the training. METHODS: All patients presenting to the district hospital with corneal disease for a 15 month period before intervention and a 12 month period after intervention were enrolled in the study. Interviews and examinations were carried out by the same person using a standardised, pretested form. RESULTS: Among the 175 pre-intervention and 97 post-intervention patients, delay in presentation improved only slightly. Blindness among patients reporting the use of TEM decreased from 44% to 21%; bilateral corneal disease in patients using TEM decreased from 31% to 10%. Multivariate analysis demonstrates that poor vision in corneal disease patients continues to be associated with TEM use and distance from the district hospital. CONCLUSION: As there were no other relevant eye health programmes in the district it is believed that this collaborative eye care programme with the traditional healers was likely to have been responsible for many of the changes in the pattern of corneal disease in the district. Although the changing patterns are encouraging and are likely to improve with additional collaboration, distance to a district hospital will continue to be a barrier to timely use of Western eye care services.
Blindness↗
Approaches of South African traditional healers regarding the treatment of cleft lip and palate.
OBJECTIVE: Due to the large number of Black South Africans known to consult with traditional healers and the influential role they play in the developing world, this study investigated the approaches of a group of 15 traditional healers toward the treatment of cleft lip and palate. DESIGN: An exploratory-descriptive, qualitative research design was employed, which involved the use of standardized, semistructured interviews, conducted with the assistance of an interpreter who was fluent in several African languages. SETTING: Interviews were conducted outdoors in places in which traditional healers usually consult with their patients. These areas were in the fields close to the traditional healers' homes or under a highway bridge in the Johannesburg inner city. PARTICIPANTS: Individual interviews were conducted with 15 African traditional healers who had been practicing in their callings for at least 1 year. RESULTS: Traditional healers interviewed had treated one to six persons with a cleft lip, cleft palate, or both. Most informants believed that clefts were caused by the ancestors, spirits, and witchcraft. A variety of plant and animal products were used to treat these conditions and were augmented by spiritual resources from the ancestors. All except one healer had undergone formal training, although they had received no specific training relative to cleft lip and palate. Most participants reported referring patients to Western health care practitioners who were referred to as modern doctors but did not receive reciprocal referrals from these professionals. Patients generally consulted with traditional healers because this approach was part of their culture. CONCLUSIONS: These findings have important implications for health care professionals as well as traditional healers in terms of cross-cultural consultation, collaboration, and information sharing with regard to cleft lip and palate; the potential use of traditional healers in primary health care and education; and further research.
Adult↗