Integrated Health Care Systems and Indigenous Medicine: Reflections from the Sub-Sahara African Region

Beth Maina Ahlberg

doi:10.3389/fsoc.2017.00012

Abstract

Indigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to contribute to strengthening the health care systems in low income countries. This paper examines the state of traditional medicine using evidence from three case studies in Central Kenya. While the cases are too few to represent the broad diversity of cultures and related healing systems in the Sub-Sahara African Region, the way they seem to refute the main assumptions in the integration discourse is important, also because studies from other countries in the region report perspectives, similar to the case studies in Kenya. It is often argued that people continue to use traditional medicine because it is affordable, available and culturally familiar. Its integration into the health care system would therefore promote cultural familiarity. The case studies however point to the loss of essential cultural elements central to traditional medicine in this particular area while users travel long distances to reach the healers. In addition, there are significant paradigm differences that may present obstacles to integration of the two systems. More problematic however is that integration is, as in many development interventions, a top-down policy which is rarely based on contextual realities and conditions. Instead, integration is often defined and dominated by biomedical professionals and health planners who may be unfamiliar or even hostile to some aspects of traditional medicine. Furthermore, integration efforts have tended to embrace selected components mostly herbal medicine. This has led to isolating herbal medicine from spiritualism, which may in turn affect the holistic perspective of traditional medicine. While familiarity and relevance may explain the continued use of traditional medicine, its services may not be as readily available, accessible or even affordable as is often asserted. Globalisation set in motion through colonization and ensuing modernization processes, including urbanization, education, religion and a neo-liberal economic system, have introduced a social order creating physical as well as social distances between users of traditional medicine and the healers.

Highlights

AND BACKGROUNDIndigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to facilitate reaching the goal of health for all, in low income countries
Being part of the culture, it is Integrated Health Care Systems argued that people readily accept it because it is familiar, the three cases observed in Kenya indicate just how unfamiliar users can be
Because of the silence on issues of sexuality, expressive methods such as local proverbs, role plays, relevant videos, and past cultural practices were used in part to make an invisible problem visible and facilitate discussion and reflection the traditional healers were visited to explore how they engaged with HIV/AIDS

Summary

INTRODUCTION

Indigenous or traditional medicine has, since the 1970s, been widely regarded as a resource likely to facilitate reaching the goal of health for all, in low income countries. According to a UNICEF study (2010), “the coming of capitalism and creation of wealth among a limited group has led to increased jealousy and envy.” Mildnevora (2016) argues that while the discourse surrounding witchcraft in Zambia integrates both modern and traditional elements, it reflects on the deprivation of ordinary people as a result of economic marginalization These developments can explain the current witch-hunts and persecution of those considered to be witches, which according to the UNICEF study (2010) is prevalent in all countries in Sub-Saharan Africa.

METHODS

A SHORT REVIEW OF INTEGRATION EFFORTS

Findings

DISCUSSION AND CONCLUSION