Abstract
Ukuhanjwa illness was used as an example to understanding abantu illnesses. With attributional theory ukuhanjwa illness is attributed to spiritual and social causes rather than biomedical causes, whereby causal link is socially constructed between ukuhanjwa illness and entry into the body by familiars. Issues explored included conceptualisation of ukuhanjwa illness. The focus of the chapter is on the reasons for continued pluralistic tendencies in healing regardless of the expectation by the West that people should be focusing on the use of the fast evolving biomedical healing methods. The ethnographic study took place among the Southern Nguni people of OR Tambo District Municipality (ORTDM) in the Eastern Cape, South Africa. Data was collected using qualitative and ethnographic research methods amongst a sample group of 50 participants. The sample was composed of traditional healers, mothers of children who have experienced ukuhanjwa illness, elderly people (male and female), biomedical practitioners and nurses.
TopIntroduction
The chapter begins by presenting the background for the discussion by outlining the description and identifiable symptoms of ukuhanjwa illness; aetiology of ukuhanjwa illness; and dealing with illness and disease in order to have better understanding of the illness in question. The chapter has also outlined the focus of the discussion as the rationale for the Southern Nguni people to continue to engage in pluralistic tendencies in healing ukuhanjwa as one of the abantu illnesses regardless of the expectation by the West that people should be focusing on the use of the fast evolving biomedical healing methods. Ngubane (1977) in Urbasch (2003, p. 11) defined abantu illnesses as spiritually caused illnesses which can only be healed using traditional healing methods. Pluralistic approach has been found to be popular even in other developing countries such as India (Whiting, 1977, p. 249). Dayes (2014) has also noted that people resort to pluralistic tendencies in healing medically unexplained symptoms. The chapter reveals how the Southern Nguni people attach different interpretations and meanings to their illnesses and health experiences as one rationale for people to engage in pluralistic tendencies in healing as their response. The chapter specifically looks deeply into the phenomenon of invisibility of ukuhanjwa to the biomedical health system within the context of power relations between the two medical systems – the biomedical and the traditional as another rationale for the use of pluralistic approach in healing ukuhanjwa illness. Invisibility has both literal and contextual meanings in relation to ukuhanjwa. The invisibility of ukuhanjwa to biomedical diagnosis has also been addressed as part of a discourse which needs to be viewed either within its historical, political or cultural setting (Lupton, 2012, p. 2). The chapter has mainly focused on the cultural setting. This discourse also includes the concept of ritual purification, for without such discourse the term is apt to be seen as directly contradicting the literal meaning of the word - pure (Good, 2001, pp. 92-103).
Pluralism is often the result of beliefs that certain illnesses are invisible when using biomedical means of diagnoses. The Southern Nguni people also view pluralistic healing method as the holistic approach in healing ukuhanjwa illness – hence this has been discussed under rationale for pluralistic tendencies in healing. The chapter also addresses the perceived source of the healing power as a powerful motivation for continued use of traditional healing methods for ukuhanjwa and how it can be linked to pluralistic tendencies in healing.
Lastly, the chapter presents solutions and recommendations highlighting the implications of the Southern Nguni beliefs and cultural practices regarding health, illness and medicine and how those implications relate to the biomedical health sector domination as well as attempts to introduce social change.
Key Terms in this Chapter
Ritual: Religion in action whereby an act is done in a particular situation in a set precise manner which is the same each time it is performed for the relief of anxiety. The term has also been circularised whereby a ritual becomes any act that is regularly repeated in a set precise manner.
Traditional People: People who still strongly believe in traditional practices irrespective of their level of education (literate or illiterate), location (urban or rural), or status (rich or poor). These traditional practices could be purely indigenous, or indigenised.
Ritual Purification: Any method which is used to heal a spiritually-caused illness or cleanse a polluted person so as to prevent illness or misfortune. This cannot be equated with physical cleanliness.
Traditional Medicine: Medicine that is based on theories, beliefs and experiences indigenous to different cultures used in the maintenance of health as well as in the prevention, improvement and treatment of physical and spiritual illnesses. Traditional medicine could be both indigenous and indigenised.
Indigenous: Anything that is endemic to a place or a group who use it in ways it was originally intended to be used.
Invisibility: The Southern Nguni contextual meaning of invisibility of abantu illnesses is means the inability of the outsider to link the symptoms of abantu illnesses to their causes as understood by the Southern Nguni people in order to be able to prescribe the correct healing method.
Pluralistic Healing Method: The use of traditional and biomedical healing approaches simultaneously or use of traditional healing approach in the beginning and at a later stage use of biomedical healing approach as a last resort or use of biomedical healing approach in the beginning and at a later stage use of traditional healing approach as a last resort.
Abantu Illnesses: Spiritually caused illnesses which can only be healed using traditional healing methods.
Cultural Modernity: Anything which is considered to be modern but still has traces of the culture of a particular group of people. This could be clothes, type of education, types of behaviour, etc.
Indigenised: Anything that is considered to be modern and is used in ways not foreseen by the manufacturer in order to suit the needs of the group of people who use it.