Traditional Healing and Western Medicine: Segregation or Integration?

Traditional Healing and Western Medicine: Segregation or Integration?

by Caroline Kangwa, November 18, 2010, Milligan College, Tn., USA

Abstract

In recent years, we have witnessed the popularization of traditional healing due to its holistic approach. More and more people are opting for alternative medical interventions as opposed to western medicine. The tension that exists between traditional healing and western medicine can be resolved. This is an issue that deserves attention as it is crucial to the optimization of the best health care choices available to every human being. The paper analyses the major differences between traditional healing and western medicine, emphasizing the beneficial aspects of traditional healing. Two groups of people are examined, the Zulus in South Africa and the Native Americans. It advocates integration as the best choice for medical intervention and gives examples where effort has been made towards this position. Integration is the best choice as it fosters good relationships between traditional healers and western medical practitioners and encourages the continuity of health care in the nursing process.

A Dynamic Tension Between Traditional Healing and Western Medicine

Tension exists between traditional healing and western medicine due to lack of trust and mutual understanding. Grandmother Luciana was highly suspicious of anything western, including the benefits of western medicine. Whenever someone was taken to the hospital, grandmother had no hope that she was ever going to see them again. She had instructed the family to only take to the hospital when she was dead, and we honored her desire. Probably, the only way that grandmother would have gone to the hospital was if the two worlds were integrated. Then, only then would have grandmother Luciana stopped saying, “They have taken so and so to the hospital to die” or take me to the hospital only when I am dead.” When we were growing up in Africa, the hospital was not considered a good place to go when one got sick. Most patients were taken to the hospital when they became critically ill, and sometimes the critically ill were taken out of the hospital by the family members in order to seek traditional healing provided by were then termed as witchdoctors, now commonly known as medicine men. Syncretism was the social norm for most Africans who could not fully identify with western customs and culture. My sister Julian would experience what seemed like some kind of anxiety or asthmatic attack whenever she got extremely upset about something. My grandmother told us that she was demon possessed and that we were to be careful with her as not to trigger that strange behavior. Hence the witchdoctor (medicine man) was called. It was forbidden to take her to the hospital as that would have killed her since western doctors did not understand the spiritual aspect of demonic possession. Western medical interventions at the hospital were totally granted from a western viewpoint, which was scientific and rational. Traditional healing was administered from an African world view, which was spiritual and some might say irrational. The two worlds had significant differences in their world view because of lack of compromise and mutual understanding. Integration as the best choice would eliminate fear, mistrust and allow for the continuity of health care without disrupting cultural set backs.

Missionary doctors from America and Europe discarded unique beliefs and practices of the locals as belonging to the devil. Ethnocentrism and colonialism fostered mistrust and resentment in relationships, thus creating tension between traditional healing and western medicine. Therefore, western medicine was regarded as the medicine of the oppressor. Missionary doctors could not understand why patients got taken out of their clinics when they became critically ill. What they failed to grasp was that in South Africa, ancestral worship was, and still is a cultural belief and practice entrenched into the very fabric of the worshipers’ existence. Therefore, when a Zulu patient became critically ill, the final authority on his disease’s diagnosis and prognosis were his ancestral spirits. Ironically, the dead ancestors dictate the well being of the living. The spiritual realm causes the natural to be or not to be. Like the Native American, the Zulus’ world was inseparable from the spirit world. In fact, the most beautiful and simple interpretation of how everything ‘IS’ can be found in the Native American tradition. “Everything in the universe is Spirit, each thing in it is of the same Spirit and it is all connected.” (Neddermeyer 2006) This approach may sound irrational when compared with the western view, but the local people’s belief in ancestral worship did in fact determine whether they responded to western medical interventions or not.

Sensitivity to the cultural beliefs of the indigenous tribes is crucial in order for any western medical intervention to be successful. Western missionaries from America and Europe made a great error by equating traditional healing in African and other parts of the indigenous world with evil practices. In an intercultural communications study conducted by Wooley and Professor Lowenberg , “A tribal world view may be characterized as polytheistic or animistic. The word “animism” means “soul” and is described as “a belief in spiritual beings concerned with human affairs and capable of helping or harming men’s interest” (Wooley & Lowenberg 1997) and the former, “polytheism” means belief in many gods. This tribal world view did not align itself with the missionaries’ belief in one almighty being (God) who was the final authority on everything. Therefore, they condemned everything tribal as devilish. This did not help to build rapport between the people and themselves. Instead, mistrust became the basis of their interaction because the indigenous people had no faith in western medicine as it negated what they believed to be the source of illness and also practically discarded their spiritual beliefs and practices as irrational and evil. How does the western doctor incorporate the cultural beliefs and practices of the indigenous people? How does he achieve the synthesis needed for his successful medical intervention? For western doctors and nurses, appreciating the holistic approach of indigenous tribes would be a great step towards the effort to integrate between traditional healing and western medicine.

Two World Views: One World?

The fundamental differences in how we perceive our world have a great influence on what type of health care we seek. Basically, we can divide world views into two major separations, the spiritual and the scientific. Despite the advance in technology and science, some groups of people are still greatly influenced by their spiritual perception of the world. World views and cultural practices do interfere with medical treatment. In contrast with the traditional healer, the western doctor is usually scientific in his approach. Whatever he is seeking to cure is found in the test tubes, is visible and can be dealt with using modern medical interventions. In the study conducted by Igor Kononenko of the University of Lijubljana in Slovenia, he analyses the differences between western medicine and healing, “healing” basically referring to alternative medicine. He adequately summarizes the main points that set the two world views apart.

“Science is based on intellect, spirituality is based on heart…Scientists recognize and investigate (only) matter, mystics investigate consciousness and are aware of different levels of human beings: spiritual (free will, unconditional love and universal intelligence), psychic (mental and emotional), and physical…material).” (Kononenko 2001)

What science does not realize is that in order for authentic healing to occur, both the logical mind and the intuitive mind must be integrated. The world view of the Zulus and the Native Americans integrate the natural and the supernatural worlds. Both the Zulus and the Native Americans acknowledge that there are forces outside their natural realm that influence and affect them as people and have influence on their health. In order for one to be successful in the natural, the supernatural must be recognized and honored. This world view is spiritual and is revered among its adherents and has great influence on how the two indigenous groups of respond to western medical interventions.

The etiology of diseases is one major difference between western medicine and traditional healing. Numerous studies have proved that there is a high correlation between belief and practice. In health care, providers are now in agreement that one’s cultural beliefs is a determinant factor in what kind of medical intervention sought. In his study of the “Religious Systems of the Zulus”, Callaway demonstrates what happens when someone gets sick and believes their ancestral spirit are the cause. They will not seek western medical intervention, but traditional healing because the spirits must be appeased. (Callaway 1870) This was revealed in a study conducted by Macfarlane about the treatment-seeking behavior of the Nasioi people of Papua New Guinea. It was discovered that the Nasioi patients were still subscribing to traditional healing. (Macfarlane 2009) In another study conducted in South Africa, the researchers discovered that the Zulu AIDS patients were not adhering to the life-saving Antiretroviro therapy (ART), but instead were reverting back to their traditional healing and ancestral practices. (Merten 2010) Scientifically, disease is detectable and treatable. Most diseases can in fact be cured, but the Zulu AIDS sufferer must consult with his ancestral spirits in order to achieve this. Scientifically if one gets sick, it is because they have come into contact with the viruses and bacteria. Western medicine’s goal is to intervene with effective measures of eliminating the source of disease, thus promoting healing. Disease is related to the finite realm and basically stays within these confines. The following table adapted by Broome in their comparative study between western medicine and Native American medicine offers interesting information on the major differences between the two practices. The western medicine’s focus is on disease and the process of eliminating it. Native American focuses on health and healing the person and community. Native American medicine focuses on the patient, his community and other spiritual, environmental, social and emotional aspects. As has already been mentioned, in the Native American world view,

“Everything in the universe is Spirit,
each thing in it is of the same Spirit
and it is all connected.”
*

Table 1

Characteristics of Western and Native American Medicine

Source: Cohen (2003). (adapted by Broome 2007)
Western Medicine Native American Medicine
Focus on pathology and curing disease. Focus on health and healing the person and community.
Reductionistic: Diseases are biological.
Treatment should produce measurable outcomes.
Complex: Diseases do not have a simple explanation.
Not always measurable
Adversarial medicine: How can I destroy disease? Teleological medicine:”What can the
disease teach the patient? Is there a message or story in the disease?”
Investigate disease with a “divide and conquer” causes and effects of disease in the physical Looks at the “big picture:” the emotional, environmental, social and spiritual realms.
Health history focuses on patient and family. Health history includes the environment.
Intellect is primary Intuition is primary. Healing is based on spiritual truths.
Physician is an authority. Healer is a health counselor and advisor

The previous table demonstrates the major differences between traditional healing and western medicine. Their focus are different and has a major influence on how each worldview approaches healing. The etiology of disease among the Zulus is demonstrated in another study by Henry Callaway. The research demonstrates what happens when someone is ill, particularly when he has been dreaming of the dead, quote from Umpengula Mbanda a native Zulu, as cited by Callaway in his study of the “Religious System of the Amazulus”.

“…He dreams perhaps of the dead man, and then has pain in his body; in the morning he tells others his dreams… When So-and-so comes to me by night, my body is in pain. The doctor says to him, “Look; when you dream of him, take this medicine and chew it; then take a stone or a piece of firewood, and spit on it the spittle which is in your mouth when you dream of him, mixed with this medicine; spit it either on a piece of firewood or on a stone; and throw it behind your back without looking. If you look the dreams will recur…” (Callaway 1870)

The Zulus also believe that disease manifests because of the moral wrong that has been committed or lack of respect for the ancestral spirits. A mixture of medicine is concocted to mislead the spirit. This is what is called “Laying the Itongo, or spirit” ( as cited by Callaway) This same belief existed among the Jews, the correlation between the spiritual realm and the natural. The Jews believed in appeasing their God whenever anything went wrong. The whole Old Testament is based upon the doctrine of atonement. Something has to be sacrificed in order for the world to be made right again. This was the role of the high priest. Disease had its etiology in the spiritual world.

One interesting point of study is the medicine wheel of the native Americans. It proves the all-encompassing world view of the Native Americans. The medicine wheel addresses four aspects of man’s composition, “the mind, body, emotions and spirit”. (McCabe 2008) Note the “spirit” and “soul”. Western medicine, without objectivity can fail to comprehend this aspect of man, except for the psychologists whose interest is the mind. Even then, western psychologists have limitations too. The mind is encased in matter, and their focus is that what happens in the natural realm affects matter through the function of the mind. Eventually, the goal will be to eliminate the source of the disturbance, the destructive environment or people. Therefore, we can conclude that even western psychology does not really have a spiritual world view, although it deals with the mind. Ironically, the term “psyche” does not only refer to the mind but also to the “soul”. To the psychologist, disease and mind problems are still matter-related. Herein lies the major disparity between western medicine and traditional healing. For the Native Americans and the Zulus, disease has a spiritual cause.

How then does the spiritual world view of the Zulus and the Native Americans influence the kind of medical interventions they seek? What is their approach to modern medicine? Does it promote healing? Both the Zulus and the Native Americans hop from one medical intervention to another. Western medicine has not replaced traditional healing. The approach of western medical practitioners to the indigenous people seeking western medical help would either promote healing or negatively affect the healing process. Lack of understanding of what traditional medicine entails would turn away some Zulus and Native Americans who strongly believe in this intervention. A study conducted by MacFarlane about the Nasioi people of Papua New Guinea revealed that the government of Papua New Guinea had introduced a policy that sought to integrate the Nasioi’s traditional medicine with western medicine. It is an attempt to implement the policy of integration, beginning with the initial gathering of information about traditional healing that would assist them in this endeavor. The researchers discovered that the Nasioi subscribed to both western as well as traditional medicine. Although they had assimilated western medicine, it had not replaced traditional healing. (Marfarlane 2009)

Areas of Concern: Is it safe?

It traditional healing safe to practice? We should approach the issue of traditional healing with caution. Dosage calculations is intuitive among the traditional healers. This is definitely one area of concern for the western medical practitioner. Grandmother Luciana would make you drink unmeasured liters and liters of the liquid from the boiled eucalyptus leaves. What if too much of that was detrimental? The other question is, would consistent dosages be established among traditional healers? Some traditional practices and beliefs can in fact prove detrimental to the participant. A study conducted about the rites of passage performed by the Venda people in South Africa sometimes prove harmful to the young men who do not fully understand why they are going through the initiation into the adulthood. The rites of passage are basically the cultural practices that are performed in order to initiate a boy into manhood. It was discovered that the initiation schools were not using the opportunity to disseminate information about AIDS and responsible sex. Some of the participants in the initiation thought they were encouraged to engage in sex in order to prove their manhood. (Malisha 2008)This is one where situation the modern approach to medicine would do a whole lot of good for the people. Western medicine would incorporate formal education in the initiation schools and also encourage the use of sterile equipment in performing the circumcisions, which are part of the initiation. Traditional healing and practices are not scientific and measurable. Traditional healers are not very careful of the environment in which they practice. In other words, they do not seem to be concerned about the pathogens. How can they be if they attribute disease to ancestral spirits? Obviously, understanding the culture of the people is very important for any form of compromise to be reached. In fact, Matheson in her research based in Angola concluded that understanding western modernity which is the basis of modern medicine is crucial to understanding the tension between western medicine and traditional healing. She discovered that understanding one’s culture can also be a clue in dealing with the other culture. Her study showed why the Angolan world view does not grasp the patients’ rights and and human rights. The community oriented world view clashes with western individualism, therefore in Angola, the patient’s right to confidentiality cannot be fully comprehended because it is based in western modernity. Therefore, in understanding one’s cultural views and how they are perceived in other cultures is important in order to be an effective medical and nursing practioner. (Matheson 2009)

An idea whose time has come

Alternative medicine has been steadily gaining prominence in the world of medical practice. (Moodley 2008) But is integration between western medicine and traditional healing an idea whose time has come? Another study conducted among the Anishinabe Indian tribe also proves that traditional healing is becoming more and more popular because of its holistic approach to human health. It incorporates both the spirit and the body. Healing is not just a result of biomedical degeneration, but is connected to the very universe that man lives in. The role of the Anishinabe man healer in the modern world was explored. (Roxanne 2008) Enough evidence from around the world demonstrates that integration can be realized. In order to optimize health among the Native Americans, the World Health Organisation had encouraged the integration of traditional healing and western medicine. It was recognized that the focus of the American Indian in health is to restore balance and harmony between the spirit and the body. (Broome 2007) In acknowledging this, western medicine is in fact respecting a group of people, the significance of their culture and how it impacts the medical world. Building this kind of rapport between the indigenous people will optimize the options available to the human race in treating disease and promoting healing. Ethnocentricity has no place in this new relationship between the two worlds. It sounds like Utopia. It is idealistic in nature, but unlike mere utopian sentiments, integration has already been achieved in some parts of the world. The twenty first century is ushering in a radical way of relating with indigenous people. Without corporation and collaboration, success is not possible. In opting for integration, we must realize that we are seeking the best alternatives for medical interventions. This will optimize the options for
healing. This approach is radical and requires patience and understanding of the unique groups of people whose values and beliefs are not determined by western modernity, but by their spirituality which permeates every fabric of their existence and understanding of the world as it is. The idea of integration demands humility on the western medical and nursing professionals who must endeavor to understand that other cultures have something special to offer in the medical field. Later on, I discovered that my grandmother’s boiled eucalyptus leaves did actually have medicinal elements that aid in breathing. Whenever we had coughs, she would boil those leaves and demand that cover ourselves under a blanket and breathe in the eucalyptus steam. One sauna I went to used eucalyptus aromatherapy in achieving maximum relaxation.

Governments and policy makers should all be engaged in promoting integration, an idea whose time has definitely come. Professional health care workers should address the areas of concern and conduct studies as to how to achieve safety in the new and radical integrated approach to healing. The health care systems should be revamped and encouraged to accommodate other cultural approaches to healing that are different from western medicine. Education about other cultures should be included in the health education curriculums. One study conducted among the Zulus in South Africa depicted the beliefs and practices of the traditional healers of South Africa in relation to HIV/AIDS/STI/TB infections. It demonstrated some of the risk practices that these healers are involved in. . It involved 223 traditional healers from Kwa- Zulu Natal in South Africa. The case study proved that there was still knowledge deficiency among the traditional healers concerning HIV/AIDS and risk practices. For instance, some of them would use the same razor blade to perform their incisions.(Peltzer 2006) As we seek the idea of integration, we should realize education is the first step to take. We cannot underestimate the statement that “Knowledge is power”. Traditional healers should learn about universal precautions in their practice. The goal is to seek the best option for every human being seeking health, because good health is one of the fundamental human rights. A study conducted in South Africa showed why some AIDS patients were not adhering to the life-saving Antiretroviral Therapy(ART) (Merten 2010) The patients’ cultural beliefs and practices were interfering with the AIDS treatment. Maybe this could be avoided in other parts of African, if integration is fully realized.

The Optimal Choice

Through this comparative study, we conclude that the best medical intervention is not segregation, but integration of the two medical approaches to healing. The tension between western medicine and traditional healing can be resolved. All the ten people interviewed were pro integration. Both western and traditional world views have strengths that need to be integrated in the nursing process. We have discovered that incorporating traditional beliefs and practices of the indigenous tribes in modern medicine would in fact optimize the options for healing. It would prevent the disruption that occurs in the nursing process when patients hop from one modern medical intervention to the traditional medical intervention and vice versa. When the clients feel respected and accepted, their chance for healing improves too, but when ethnocentrism rules out other unique cultural traits, beliefs and practices of other people, mistrust in the western medicine prevails, which leads to ineffective medical interventions. If grandmother Luciana felt accepted and respected, maybe she would have stopped saying, “They have taken so and so to the hospital to die.” It is a shame that she died believing western medicine had no place in her life and yet her eucalyptus leaves had in fact some medicinal qualities. She too had something to offer. Let us hope that every effort to move towards integration will be pursued and explored to its maximum potential for the sake of achieving optimal health for every ethnic group of people. “All truth is God’s truth.”

Works Cited

Broome, B., & Broome, R. (2007). Native Americans: Traditional Healing. Urologic Nursing, 27(2), 161-173. Retrieved from Health Source: Nursing/Academic Edition database.

Callaway, Henry. (1870). The Religious Systems of the Amazulus. Retrieved from http://www.sacred-texts.com/afr/rsa/index.htm (Reduced to HTML by Christopher M. Weimer, March 2003)

Kononenko, Igor Western medicine and traditional healing University of Ljubljana, Faculty of Computer and Information Science Trzaska 25, 1000 Ljubljana, Slovenia Retrieved from http://www.google.com/search?sourceid=ie7&q=western%2Bmedicine%2BVs%2BTraditional%2Bhealing&rls=com.microsoft%3Aen-us%3AIE-SearchBox&ie=UTF-8&oe=UTF-8&rlz=1I7TSNA_enUS356US355

Macfarlane, J., & Alpers, M. (2009). Treatment-seeking behaviour among the Nasioi people of Bougainville: choosing between traditional and western medicine. Ethnicity & Health, 14(2), 147-168. doi:10.1080/13557850802546588. Retrieved from Health Source: Nursing/Academic Edition database.

Malisha, L., Maharaj, P., & Rogan, M. (2008). Rites of passage to adulthood: traditional initiation schools in the context of HIV/AIDS in the Limpopo Province, South Africa. Health, Risk & Society, 10(6), 585-598. doi:10.1080/13698570802533713. Retrieved from Health Source: Nursing/Academic Edition database.

Matheson, D. (2009). A right to health: Medicine as Western cultural imperialism?. Disability & Rehabilitation, 31(14), 1191-1204. doi:10.1080/09638280902773794. Retrieved from Health Source: Nursing/Academic Edition database.

Merten, Sonja, et al. “Patient-reported barriers and drivers of adherence to antiretrovirals in sub-Saharan Africa: a meta-ethnography.” Tropical Medicine and International Health 15 (2010): 16+. Academic OneFile. Web. 4 Nov. 2010.

Moodley, R., Sutherland, P., & Oulanova, O. (2008). Traditional healing, the body and mind in psychotherapy. Counselling Psychology Quarterly, 21(2), 153-165. doi:10.1080/09515070802066870.

*Neddermeyer, Dorothy M (2006) Holistic Healthcare versus Traditional Western Medicine Health and Fitness Mind Body Spirit. http://ezinearticles.com/?Holistic-Healthcare-versus-Traditional-Western-Medicine&id=139585″>

Peltzer, K., Mngqundaniso, N., & Petros, G. (2006). HIV/AIDS/STI/TB knowledge, beliefs and practices of traditional healers in KwaZulu-Natal, South Africa. AIDS Care, 18(6), 608-613. doi:10.1080/09540120500294206

Roxanne, S., Valerie S., E., & Beverly, P. (2008). THE EXPERIENCE OF BEING AN ANISHINABE MAN HEALER: ANCIENT HEALING IN A MODERN WORLD. Journal of Cultural Diversity, 15(2), 70-75. Retrieved from Health Source: Nursing/Academic Edition database.

Woolley, Douglas E., & Lowenberg, Doug. (1997) Ethnocentrism can hinder communication among those of differing World views. Retrieved from http://www.dougandmarsha.com/essays-seminary/ch15_ethnocentrism.htm

Tables

Table 1 – Characteristics of Western and Native American Medicine, Source: Cohen(2003) (adapted by Broome 2007)

Interviews

The Question, “Would you consider integrating western and traditional healing?”

Participant Answer
1. Jenny Chellah (nursing student, Milligan College) Yes
2. Deborah Howerton (Prayer Intercessor) Yes
3. Nicole Bennet (nursing student) Yes
4. Patrick Chellah (Theology student) Yes
5. Pai Mushayamunda (History major) Yes
6. Peter Nyirenda (Law student) Yes
7. Stanislava Ivanova (Bulgarian, speech therapist) Yes
8. Aldorphia Lane (Truck Driver) Yes
9. Edward Bell (Computer engineering) Yes
10. Doris Fahngon (nursing student) Yes