The Perceptions and Motivations of Communities in Seeking Indigenous Healing in Cases of Mental Illness in Zimbabwe
We aimed to investigate perceptions of the IH practices in order to understand the role of the IHPs in mental health care. We recruited a total of 60 key informant participants, 30 IHPs, and 30 patients of the IHPs, at the IHPs’ shrines in a settlement 16 kilometres north-east of Harare, in Zimbabwe. Gathered data were coded using constant comparison method with multiple members of the research team, enhancing validity and reliability. Our results revealed that there were many healing orders in Zimbabwe and the main ones were the herbalists, the spirit mediums, the diviners and the faith healers. The IHPs saw patients with mental disorders that were consistent with the BT diagnoses, and others with disorders that were non-existent in the BT. Common disorders to both IHPs and BTPs were the schizophrenia (kurasikapfungwa), depression (kusuruvara), anxiety (kufunganya), etc. Disorders unique to IHPs included supernatural, cultural or social problems and examples were mamhepo (bad airs), witchcraft (zvehuroyi) perceived to arise from evil minded people, and ngozi (aggrieved spirit). The IHPs used unique healing methods which included use of herbs, healing spirit, including counselling patients which involved use of rituals and prayer. On discharge and follow up, the patient was either given the medication to use later at their house; or a date to come for review; or a referral to a hospital for further management. In providing the service that catered for the supernatural factors, the approach met the cultural expectations of the patients unlike the BTPs who failed to cater for this service. The IHPs therefore, provided a unique therapy to patients in Zimbabwe. The IHPs should therefore be yoked with the BTPs in order to create a holistic therapy which cater for the body-mind and spirit. More research is required to test the IHPs’ characteristics before their adoption into therapy.
Health-seeking Behaviour, Indigenous Healing, Indigenous Healing Practitioner, Mental Disorders
Cross, T. L. (2003). Culture as a resource for mental health. Cultural Diversity and Ethnic Minority Psychology, 9 (4), 354.
Machinga, M. (2011). Religion, health and healing in the traditional Shona culture of Zimbabwe. Practical Matters, 4, 1–8.
Liverpool, J., Alexander, R., Johnson, M., Ebba, E. K., Francis, S., & Liverpool, C. (2004). Western medicine and traditional healers: partners in the fight against HIV/AIDS. Journal of the National Medical Association, 96 (6), 822.
Oliver, S. J. (2013). The role of traditional medicine practice in primary health care within Aboriginal Australia: a review of the literature. Journal of Ethnobiology and Ethnomedicine, 9 (1), 46. https://doi.org/10.1186/1746-4269-9-46
Shoko, T. (2008). Karanga traditional medicine and healing. African Journal of Traditional, Complementary and Alternative Medicines, 4 (4), 501–509.
Sandlana, N., & Mtetwa, D. (2008). African traditional and religious faith healing practices and the provision of psychological wellbeing among amaXhosa people. Indilinga African Journal of Indigenous Knowledge Systems, 7 (2), 119–131.
Elujoba, A. A., Odeleye, O. M., & Ogunyemi, C. M. (2005). Review-Traditional medicine development for medical and dental primary health care delivery system in Africa. Retrieved from https://tspace.library.utoronto.ca/handle/1807/9189
Ahmed, I. M., Bremer, J. J., Magzoub, M. M., & Nouri, A. M. (1999). Characteristics of visitors to traditional healers in central Sudan. Retrieved from http://apps.who.int/iris/handle/10665/118687
Madiba, S. (2010). Are biomedicine health practitioners ready to collaborate with traditional health practitioners in HIV & AIDS care in Tutume sub district of Botswana. African Journal of Traditional, Complementary and Alternative Medicines, 7 (3). Retrieved from http://www.ajol.info/index.php/ajtcam/article/view/54779
Berg, A. (2003). Ancestor reverence and mental health in South Africa. Transcultural Psychiatry, 40 (2), 194–207.
Patel, V., Araya, R., Chatterjee, S., Chisholm, D., Cohen, A., De Silva, M., … van Ommeren, M. (2007). Treatment and prevention of mental disorders in low-income and middle-income countries. The Lancet, 370 (9591), 991–1005.
Michaud, C. M., Murray, C. J., & Bloom, B. R. (2001). Burden of disease—implications for future research. Jama, 285 (5), 535–539.
Watts, S. C., Bhutani, G. E., Stout, I. H., Ducker, G. M., Cleator, P. J., McGarry, J., & Day, M. (2002). Mental health in older adult recipients of primary care services: is depression the key issue? Identification, treatment and the general practitioner. International Journal of Geriatric Psychiatry, 17 (5), 427–437.
Woldetsadik, M. A. (2015, March 10). Mental Health Care in Sub-Saharan Africa: Challenges and Opportunities. Retrieved April 5, 2018, from https://www.rand.org/blog/2015/03/mental-healthcare-in-sub-saharan-africa-challenges.html
Cohen, A., Organization, W. H., Organization, W. H., & others. (2001). The effectiveness of mental health services in primary care: the view from the developing world. Mental Health Policy and Service Development, Department of Mental Health and Substance Dependence, Noncommunicable Diseases and Mental Health, World Health Organization.
Chibanda, D., Mesu, P., Kajawu, L., Cowan, F., Araya, R., & Abas, M. A. (2011). Problem-solving therapy for depression and common mental disorders in Zimbabwe: piloting a task-shifting primary mental health care intervention in a population with a high prevalence of people living with HIV. BTC Public Health, 11 (1), 828.
Reeler, A. P., Mbape, P., Matshona, J., Mhetura, J., & Hlatywayo, E. (2001). The prevalence and nature of disorders due to torture in Mashonaland Central Province, Zimbabwe. Torture, 11, 4–9.
Patel, V., Todd, C., Winston, M., Gwanzura, F., Simunyu, E., Acuda, W., & Mann, A. (1998). Outcome of common mental disorders in Harare, Zimbabwe. The British Journal of Psychiatry, 172 (1), 53–57.
Patel, V., Musara, T., Butau, T., Maramba, P., & Fuyane, S. (1995). Concepts of mental illness and medical pluralism in Harare. Psychological Medicine, 25 (3), 485–493.
Broadhead, J. C., & Abas, M. A. (1998). Life events, difficulties and depression among women in an urban setting in Zimbabwe. Psychological Medicine, 28 (01), 29–38.
Patel, V., Simunyu, E., & Gwanzura, F. (1997). The pathways to primary mental health care in high-density suburbs in Harare, Zimbabwe. Social Psychiatry and Psychiatric Epidemiology, 32 (2), 97–103.
Weine, S., Danieli, Y., Silove, D., Ommeren, M. V., Fairbank, J. A., & Saul, J. (2002). Guidelines for international training in mental health and psychosocial interventions for trauma exposed populations in clinical and community settings. Psychiatry, 65 (2), 156–164.
Chitindingu, E., George, G., & Gow, J. (2014). A review of the integration of traditional, complementary and alternative medicine into the curriculum of South African medical schools. BTC Medical Education, 14 (1), 40.
Patel, V., Todd, C., Winston, M., Gwanzura, F., Simunyu, E., Acuda, W., & Mann, A. (1997). Common mental disorders in primary care in Harare, Zimbabwe: associations and risk factors. The British Journal of Psychiatry, 171 (1), 60–64.
Gunda, M. R. (2007). Christianity, Traditional Religion, and Healing in Zimbabwe: Exploring the Dimensions and Dynamics of Healing Among the Shona. Swedish Missiological Themes, 95 (3), 232.
Nortje, G., Oladeji, B., Gureje, O., & Seedat, S. (2016). Effectiveness of traditional healers in treating mental disorders: a systematic review. The Lancet Psychiatry, 3 (2), 154–170. https://doi.org/10.1016/S2215-0366(15)00515-5
Pienaar, A. (2014). Mental Health Care in Africa: An Evidence-based Approach. - Google Search. Retrieved from https://www.google.com/search?client=firefox-b&biw=1366&bih=604&ei=qYnxWYS3Cs7RwQKLr5zwDA&q=+Mental+Health+Care+in+Africa%3A+An+Evidence-based+Approach.+&oq=+Mental+Health+Care+in+Africa%3A+An+Evidence-based+Approach.+&gs_l=psy-ab.12...923009.928855.0.9323188.8.131.52.0.0.0.608.608.5-1.2.0....0...1.1j2.64.psy-ab..0.1.892.6..35i39k1.894.OrGxgP9Tj5Y
Mhame, P. P., Busia, K., Kasilo, O. M., & Mhame, P. P. (2010). Clinical practices of African traditional medicine. The African Health Monitor, 32–39.
Cumes, D. (2013). South African indigenous healing: how it works. Explore (New York, N.Y.), 9 (1), 58–65. https://doi.org/10.1016/j.explore.2012.11.007
Ngoma, M. C., Prince, M., & Mann, A. (2003). Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania. The British Journal of Psychiatry: The Journal of Mental Science, 183, 349–355.
Sodi, T., & Bojuwoye, N. (2011). Cultural embeddedness of health, illness and healing: Challenges for integrating traditional healing and western oriented health care systems. Journal of Psychology in Africa, 21 (3), 349–356.
Sobiecki, J.-F. (2012). Psychoactive ubulawu spiritual medicines and healing dynamics in the initiation process of Southern Bantu diviners. Journal of Psychoactive Drugs, 44 (3), 216–223.
Maluleka, J. R., & Ngulube, P. (2017). The preservation of knowledge of traditional healing in the Limpopo province of South Africa. Information Development, 026666691772395. https://doi.org/10.1177/0266666917723956
Hewson, M. G. (1998). Traditional healers in southern Africa. Annals of Internal Medicine, 128, 1029–1034. doi: 10.7326/0003-4819-128-12 [CrossRef], [PubMed], [Web of Science ®], [CSA]
Helwig, D. (2010). Traditional African Medicine. Encyclopedia of Alternative Medicine.
Chavunduka, G. L. (1994). Traditional medicine in modern Zimbabwe. Zimbabwe: University of Zimbabwe Publications 115p. ISBN, 908307403. Retrieved from http://kbd.kew.org/kbd/detailedresult.do?id=107336
Chigora, P., Masocha, R., & Mutenheri, F. (2007). The role of indigenous medicinal knowledge (IMK) in the treatment of ailments in rural Zimbabwe: The case of Mutirikwi communal lands. Journal of Sustainable Development in Africa, 9, 26–43.
Green, E. C. (2000). The WHO forum on traditional medicine in health systems, Harare, Zimbabwe, February 14-18, 2000. The Journal of Alternative and Complementary Medicine, 6 (5), 379–382.
Sandlana, N. S. (2002). The Use of Traditional African Dance and Music as a Therapeutic Technique: An Exploratory Study in Search of Psychological Wellbeing. University of Fort Hare.
Mokgobi, M. G. (2014). Understanding traditional African healing. African Journal for Physical Health Education, Recreation, and Dance, 20 (Suppl 2), 24–34.
Ovuga, E., Boardman, J., & Oluka, E. G. (1999). Traditional healers and mental illness in Uganda. Psychiatric Bulletin, 23 (5), 276–279.
Mapara, J. (2009). Indigenous knowledge systems in Zimbabwe: Juxtaposing post- colonial theory. The Journal of Pan African Studies, 3, 139–155.
Emeagwali, G. 2003. African Indigenous Knowledge Systems (AIK): Implications for the Curriculum, in Toyin Falola (ed), Ghanain Africa and the World: Essays in Honor of Adu Boahen. http://www.africa history. Net Retrieved on 08 May 2009.
Hammersmith, J. A. 2007. Converging Indigenous and Western Knowledge Systems: Implications for Tertiary Education. Unpublished Doctoral Thesis. Pretoria: University of South Africa (UNISA).
Kunnie, J. 2000. ‘Developing indigenous Knowledge and Technological systems’ in Chiwome, E. M. etal. (eds)
Gelfand, M. (1985). The traditional medical practitioner in Zimbabwe: his principles of practice and pharmacopoeia. Mambo Press.
McKenzie, K., Patel, V., & Araya, R. (2004). Learning from low income countries: mental health. BMJ, 329 (7475), 1138–1140.
Glaser, B. G., & Strauss, A. L. (2009). The discovery of grounded theory: Strategies for qualitative research. Transaction Publishers. Retrieved from https://books.google.com/books?hl=en&lr=&id=rtiNK68Xt08C&oi=fnd&pg=PP1&dq=The+discovery+of+grounded+theory:+Strategies+for+qualitative+research&ots=UVwUTlVJZP&sig=Su95_tyfwesd8nXv9dja3ZuX7Ao
LeCompte, M. D., & Schensul, J. J. (2010). Designing and conducting ethnographic research (Vol. 1). Rowman Altamira. Retrieved from https://books.google.com/books?hl=en&lr=&id=xa7oIOlCUGwC&oi=fnd&pg=PR5&dq=Designing+and+conducting+ethnographic+research&ots=n_ryshLuck&sig=qo9ymoTOj_PzbCW9-vOmhD_i0EM
Pope, C., & Mays, N. (2009). Critical reflections on the rise of qualitative research. BMJ, 339, b3425. http://doi.org/10.1136/bmj.b3425
Kumar, S., & Phrommathed, P. (2005). Research methodology. Springer. Retrieved from http://link.springer.com/content/pdf/10.1007/0-387-23273-7_3.pdf
Ritchie, J., Lewis, J., Lewis, P. of S. P. J., Nicholls, C. M., & Ormston, R. (2013). Qualitative Research Practice: A Guide for Social Science Students and Researchers. SAGE.
Parahoo, K. (2014). Nursing Research: Principles, Process and Issues. Palgrave Macmillan.
Paltved, C., & Musaeus, P. (2012). Qualitative Research on Emergency Medicine Physicians: A Literature Review. International Journal of Clinical Medicine, 03 (07), 772–789. https://doi.org/10.4236/ijcm.2012.37A136
Patton, Michael Quinn (2000). Qualitative Research & Evaluation Methods. 3rd Sage Publications, London.
Huberman, A., & Miles, M. (2002). The Qualitative Researcher’s Companion. 2455 Teller Road, Thousand Oaks California 91320 United States of America: SAGE Publications, Inc. https://doi.org/10.4135/9781412986274
Robertson, B. A. (2006). Does the evidence support collaboration between psychiatry and traditional healers? Findings from three South African studies. African Journal of Psychiatry, 9 (2), 87–90.
Agara, A. J., Makanjuola, A. B., & Morakinyo, O. B. (2008). Management of perceived mental health problems by spiritual. African Journal of Psychiatry, 11 (2), 113–118.
Ware, F. (2008). African American Folk Healing. Pneuma, 30, 367–368. https://doi.org/10.1163/157007408x346717
Taylor, T. N. (2010). “Because I was in pain, I just wanted to be treated”: Competing Therapeutic Goals in the Performance of Healing HIV/AIDS in Rural Zimbabwe. Journal of American Folklore, 123 (489), 304–328.
Zakaria, F., & Zainal, H. (2017). Traditional Malay medicine in Singapore. Indonesia and the Malay World, 45, 127–144. https://doi.org/10.1080/13639811.2017.127515
Appiah, B. (2012). African traditional medicine struggles to find its place within health care. CMAJ : Canadian Medical Association Journal, 184 (16), E831–E832. https://doi.org/10.1503/cmaj.109-4277
Chikara, F. & Manley, M. R. (1991). Psychiatry in Zimbabwe. Psychiatry Services, 42, 943–947. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1743667 [CrossRef]
Labhardt, N. D., Aboa, S. M., Manga, E., Bensing, J. M., & Langewitz, W. (2010). Bridging the gap: how traditional healers interact with their patients. A comparative study in Cameroon. Tropical Medicine & International Health, 15 (9), 1099–1108.
Mutambirwa, J. (1989). Health problems in rural communities, Zimbabwe. Social Science & Medicine, 29 (8), 927–932.