Cultural Dimensions of Health, Disease And Healing

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Cultural Dimensionsof Health, DiseaseAnd
Healing

• South Africa

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Practices and Beliefs
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African Traditional Medicine

• Sum total of all knowledge and practices used in
  diagnosis, prevention and elimination of
  physical, mental, or societal imbalance.
• Relies on practical experience and observation
  handed down from generation to generation.
• Holistic approach Physical and Spiritual
  Wellness
• Maintaining Social Relations
• Contrasting to Western medicines approach

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HIV/AIDS

• HIV believed to be caused by pollution
• Cleansing of the body to cure the disease
• Other beliefs about AIDS
• Amagobongo
• Amandawo
• Imimoya
• Ukutwasa

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Witchcraft

• Jealousy and material success
• Amagqwirha (witches)
• Imimoya emdaka (specific illnesses)
• Isidliso or Black Poison

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Psychosocial vs Biological

• Disease occurs in the individual and is the
  medical condition.
• Illness comprises of the individual, the
  culture and community.
• Both physical symptoms and social causes.
• Nana, a South African woman with HIV.
• Integration of biomedicine and traditional
  medicine.

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Choosing Among Healers
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Traditional Healers

• Herbalists Sangomas or izinyanga
• Treat with herbs, remedies and advice or counsel
• Diviners amagqirha or izangoma
• Treat by myth, spirituality, psychology and drama
• Cures social issues

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Traditional Medicine

• Animal fats and herbal medicines
• Preparation
• Infusions (Imuthi Ophuzwayo)
• Inhalants(Gquma-over steam)
• Snuff (Bema muthi)
• Licking of powder (Khota)
• Implantations under skin (Chaza)
• Enemas (Ucatha)
• Bath mixtures (Geza)
• Poultices (Izithobo)
• Fatty creams/balms (Amafutas)
• Emetics(Imithi Yokuphalaza)
• Internal cleansing (Izimbiza (Ngoma n.d.)

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Traditional Medicine

• Depends on type of illness beliefs regarding
  the cause of the illness
• 80 of South Africans use traditional medicine.
• Medical doctors 140,000
• Traditional healers 1500
• Gender and age range
• Remedial and Preventative care
• Reasons for use
• Convenience Low cost Wide variety
• No language or cultural barriers
• Effective and familiar
• Healers are trusted and part of the community

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Biomedicine

• Used first for recognizable physical ailments
• Issue of Somatization
• Private Doctors preferred over public care
• Chronic vs acute illness
• Issues Time consuming, costly, poor quality
  staffing and impersonal doctors, does not include
  social and cultural aspects.

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Structure, Culture and Health
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Social and Cultural AspectsColonial powers and
structures

• Witchcraft Suppression Acts
• Inclusion of traditional medicine to primary care
  
• WHO
• Traditional Health Practitioners Bill

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Social and Cultural Aspect Apartheid History

• Migrant labor
• Forced move to villages
• Fostering of elite bureaucracies
• Violence
• Poverty and social differentiation

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Structure and Cultural Aspect Western vs
Traditional

• Biomedicine looks at material causation
• Traditional medicine includes spiritual
  causation
• How should Government regulate?
• Integration of traditional medicine
• and biomedicine

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Social and Cultural Aspect Poverty and Lack of
Resources

• Accessibility and resources in clinics
• Community and Home-based Care (CBC)
• Need for Informal Organizations
• Shortage of staff caused by migration crisis

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THE END

• Questions?
• Comments?
• Concerns?