6(A). Traditional healing and mental health


Traditional healing – sometimes called ‘African medicine’ – acknowledges the interconnectedness of the physical world and spirituality.67 Mental health issues are understood as possession by evil spirits. They are “disturbances in the relationship between people and divinity, divine punishment for past actions, or an unbalance due to social issues”.68 Compared to psychiatric services, traditional medicine is readily available and thus more accessible to the general population.69

Many traditional healers promise effective solutions. Indeed, in 2001 the World Health Organization referred to the “demonstrated efficacy” of traditional and complementary/alternative medicine in relation to mental health.70 Others question the efficacy and ethics of traditional healing practices in various parts of Africa.71 Researches on traditional healing in Zambia have previously focussed on HIV and other sexually-transmitted diseases, epilepsy and how to build trust between traditional healers and healthcare workers.72

International law recognises traditional healing as an indigenous knowledge system.73 The right to participate in cultural, religious and scientific life of the community is guaranteed in human rights law at the United Nations74 and African levels.75 These official documents speak of the value of collaboration between practitioners of conventional and traditional medicine.76

Traditional healers are reported to fear their medicines being stolen.77 They doubt western medical doctors’ ability to cure,78 and think that physicians do not treat them with respect for their contribution to community health. Examples of collaboration include Basic Needs in Northern Ghana which initiated a programme of collaboration with traditional healers in mental healthcare, aimed at cross-referrals and mutual understanding.79 This project showed the potential for successful partnership.80

Religion plays an important role in mental health in Africa,81 but in Zambia the church appears to be minimally connected to mental healthcare in terms of providing in-patient treatment centres or prayer camps.82 However religious leaders have a critical attitude to mental health services, and their focus on prayer-as-cure inhibits the uptake of services and treatments. Some people monitors spoke to explained that relatives paid churches to pray for their mentally ill relatives. Since 1990, new Pentecostal and charismatic churches are on the rise,83 and some people have argued that the popular trend of African Pentecostalism needs to be challenged since in the long run it may reinforce beliefs in witchcraft and demon possession, instead of bringing liberation.84 Even mainstream churches have developed influential charismatic wings which have become affected by the quest of Pentecostalism and encourage people to rely on prayer.85 The lack of community psychiatric services further drives people to seek relief from churches. Hospitals allow religious people to come and pray for patients inside hospitals. Monitors witnessed this at Chainama Hills Hospital B-ward and at Kabwe Hospital psychiatric wards.

Frequently people go to traditional healers before accessing mental health services. Most people with mental health issues in Zambia have seen a traditional healer (“Ng’anga”) for support. People may also see a traditional healer at the same time as a mental health professional, or – particularly in cases of relapse – afterwards. A representative of the Human Rights Commission explained that due to the scarcity in rural areas of conventional medicine, people, “tend to rely on traditional healers and sometimes they take advantage of the vulnerability of the patient”.

Data on the numbers of traditional healers and their practices are lacking. The WHO 2001 “Strategy for the African Region on Promoting the Role of Traditional Medicine in Health Systems” estimates that one in five people living in rural areas in developing countries depend on traditional medicine for their healthcare needs. The Zambian 2005 Mental Health Policy records that 70-80% people with mental health issues consulted traditional healers before seeking help from conventional health practitioners.86 Many people with whom monitors spoke explained that the overall use of traditional healers was reducing as society had become increasingly more exposed to modern medicine and had greater understanding and access to conventional treatments.

67 Bojuwoye, “Traditional Healing Practices in Southern Africa: Ancestral Sprits, Ritual Ceremonies, and Holistic Healing”, in Roy Moodley and William West, Integrating Traditional Healing Practices Into Counseling and Psychotherapy (eds.), (Sage Publications Ltd.: 2005), at pp. 61–72.

68 See, for example, Sorsdahl et al, “Explanatory models of mental disorders and treatment practices among traditional healers in Mpumalanga, South Africa” (African Journal of Psychiatry, 13(4) (Sep 2010): 284–290); Human Rights Watch, “Like a Death Sentence”: Abuses against persons with mental disabilities in Ghana (2012), available online at: http://www.hrw.org/reports/2012/10/02/death-sentence-0 (lase accessed: 09.04.2014).

69 Jean Nagelkerk and Marian M. Tabi, “Nursing in Ghana”, Journal of Nursing Administration, 24 (1994): 17–18); Tholene Sodi, “Towards recognition of indigenous healing: Prospects and constraints”, (Journal of Comprehensive Health, 7 (1996): 5–9); Michelle Cocks and Valerie Møller, “Use of indigenous and indigenized medicines to enhance personal well-being: A South African case study”, (Social Science & Medicine, 54 (2002): 387–398); Christa Rautenbach, “Some comments on a new legislative framework for female traditional healers in South Africa”, (Emory International Law Review 22 (2008):113).

70 World Health Organisation, Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A worldwide review. (Geneva: WHO, 2001): 4. See also “Minister stresses traditional medicine in mental health”, ANGOP – Agência Angola Press, 6 October 2013, available online at: http://www.portalangop.co.ao/angola/en_us/noticias/saude/2013/9/40/Minister-stresses-traditional-medicine-mental-health,87e51efb-8b75-45c3-a784-5e4bc5dca805.html (last accessed: 09.07.2014).

71 Ae-Ngibise et al., The MHAPP Research Programme Consortium, “’Whether you like it or not people with mental problems are going to go to them’: A qualitative exploration into the widespread use of traditional and faith healers in the provision of mental health care in Ghana” (International Review of Psychiatry, 22(6) (2010): 558–567); Ursula Read, Edward Adiibokah and Solomon Nyame, “Local suffering and the global discourse of mental health and human rights: An ethnographic study of responses to mental illness in rural Ghana”, (Globalization and Health, (2009): 5-13); Human Rights Watch, “Like a Death Sentence: Abuses against persons with mental disabilities in Ghana”, supra note 68; Ehab Sorketti, Nor Zuraida Zainaland and Mohamad Hussain Habil, “The traditional belief system in relation to mental health and psychiatric services in Sudan” (International Psychiatry, 9(1) (2012): 18–19).

72 MDAC and MHUNZA literature on traditional healing and mental health in Zambia.

73 Chidi Oguamanam, “Between Reality and Rhetoric: The Epistemic Schism in the Recognition of Traditional Medicine in International Law” (Saint Thomas Law Review, 16 (2003): 59).

74 Article 27 of the Universal Declaration of Human Rights (UDHR), Article 1 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) and Article 27 of the International Covenant on Civil and Political Rights (ICCPR). See also International Labour Organisation (ILO) Convention No. 169 of 1989, part 5 under the title ‘social security and health’. Articles 23 and 24 of the UN Declaration on the Rights of Indigenous Peoples 1993 (UNDRPI) guarantees the right to traditional medicines and practices including the right to the protection of vital medicinal plants, animals and minerals.

75 Articles 17 and 29 of The African Charter on Human and Peoples’ Rights (ACHPR), Article 6 of the African Cultural Charter (ACC) and Articles 3, 13 and 21 of the African Charter on the Right and Welfare of the Child (ACRWC), The Protocol on the Rights of Women in Africa. The latter explicitly prohibits harmful practices in Articles 2 and 5.

76 Kenneth Ae-Ngibise et al., MHAPP Research Programme Consortium, “’Whether you like it or not people with mental problems are going to go to them’: A qualitative exploration into the widespread use of traditional and faith healers in the provision of mental health care in Ghana”, supra note 71; Ehab Sorketti, Nor Zuraida Zainaland Mohamad Hussain Habil, “The traditional belief system in relation to mental health and psychiatric services in Sudan”, supra note 71.

77 Santuah F. Niagia, “Traditional medicine gets healthy recognition” (The Lancet 359 (2002): 1760).

78 Katherine R. Sorsdahl, Dan J. Stein, D.J. and Alan J. Flisher, “Traditional healer attitudes and beliefs regarding referral of the mentally ill to Western doctors in South Africa” (Transcultural Psychiatry 47 (2010): 600).

79 Supra note 71.

80 Ibid.

81 Human Rights Watch, “Like a Death Sentence: Abuses against persons with mental disabilities in Ghana”, supra note 71.

82 Ibid.

83 Bernhard Udelhoven, “The changing face of Christianity in Zambia: new church of Bauleni Compound” (Faith and Encounter Centre Zambia, 2010), available online at: http://www.fenza.org/docs/ben/changing_face.pdf (last accessed: 09.07.2014).

84 Ibid.

85 Ibid.

86 Republic of Zambia, Mental Health Policy 2005, 5.

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