In Ghana, Conflict and Complementarity

Abstract

In Ghana, Conflict and Complementarity A people's approach to health care is based on their understanding of human being, life, and consequently health.[1] In Ghana, as well as other non-Western nations, the interplay of traditional modes of health care and imported medicine creates tensions for the allocation and utilization of health care resources. In a climate of increasingly scarce medical resources and cultural transition, how are these tensions to be resolved? Searching out the ways in which the indigenous and Western medical systems can complement one another offers some hope. Life, Being, and Health In indigenous Ghanaian society, being is understood basically as force. Thus human being is the immediate manifestation of spiritual force or power (God and the spirits being the ultimate sources). Human being manifests the power of both male (ntoro) and female (mogya) spirits--being brave and fierce, generative and peaceful, respectively. These male and female spirits are in fact dimensions of God. Thus, God is the ultimate source of all powers of good because they are dimensions of His being, while human being is the vehicle through which the divine manifests Himself in the universe. Accordingly, an offense against a fellow human being is regarded ultimately as an offence against his or her spirit, which requires pacification. Ghanaians see life as a total integrated, contemporaneous experience of existence in all dimensions--spiritual and physical, social and personal. Physical being is simply the physical manifestation of the spiritual force that a human being fundamentally is--a mystery even to him or herself. As L. Senghor notes: Man....as an extension of the image of God, and at the centre of created forces, lives in a community of a psycho-physical world whose solidarity and morality are upheld by the powers around him that rule the entire universe. This concept tends to enlarge the sense of community to overstep the social boundaries of a clan or tribe or even nation.[2] The individual is linked both to the material world, and through the ntoro, mogya, and their union in the person's okra (spirit or temperament), to the world of the spirit. These not only make it possible for a person to enter this world, but also guide him or her throughout life until he or she returns to the world of the spirit in death and becomes an ancestor for his or her descendants. Deviant behavior is subject to sanctions from the spiritual world, including ill-health.[3] Thus the physical state of the individual is the external manifestation of his or her spiritual-moral state. Illness is an indication of a bad spiritual-moral state, the result of moral fault of the sufferer or someone related to him or her in various ways. Unless the culprit confesses, pays for expiatory or reconciliatory ritual, and makes amends, the performance of an evil act sets in motion a progressive deterioration of the well-being of the individual and society, leading to disaster--even death--as an automatic and inescapable punishment. Certain evil acts are believed to have their corresponding types of disease. For instance, incest or adultery results in adzim, disease generally connected with all types of chest troubles and frequent coughing. The culprit is not punished by God or man; rather adzim follows directly from the individual's wrongdoing itself.[4] To restore a person's health, his or her spiritual-moral integrity must be restored by confession and rituals. This conception of health also reflects an understanding of the individual as truly human only as an integral member of the community--the mystical union of spirits, ancestors, and the living. Good health, then, is well-being as a result of personal and communal integrity.[5] Illness, correlatively, threatens not only the individual, but also the community's solidarity and security. …