African Medical Pluralism

In most places on the African continent, multiple health care options exist and patients draw on a therapeutic continuum that ranges from traditional medicine and religious healing to the latest in biomedical technology. The ethnographically based essays in this volume highlight African ways of perceiving sickness, making sense of and treating suffering, and thinking about health care to reveal the range and practice of everyday medicine in Africa through historical, political, and economic contexts.

In Biomedical Hegemony and Democracy in South Africa Ngambouk Vitalis Pemunta and Tabi Chama-James Tabenyang unpack the contentious South African government’s post-apartheid policy framework of the ‘‘return to tradition policy’’. The conjuncture between deep sociopolitical crises, witchcraft, the ravaging HIV/AIDS pandemic and the government’s initial reluctance to adopt antiretroviral therapy turned away desperate HIV/AIDS patients to traditional healers. Drawing on historical sources, policy documents and ethnographic interviews, Pemunta and Tabenyang convincingly demonstrate that despite biomedical hegemony, patients and members of their therapy-seeking group often shuttle between modern and traditional medicine, thereby making both systems of healthcare complementary rather than alternatives. They draw the attention of policy-makers to the need to be aware of ‘‘subaltern health narratives’’ in designing health policy.

The essays in the first of the three parts of the book deal with issues of illness and healing as culture. In the second part, sociological and psychological perspectives are presented and the final part is concerned with intra- and intercultural aspects of medical pluralism.

Recent political, social, and economic changes in Africa have provoked radical shifts in the landscape of health and healthcare. Medicine, Mobility, and Power in Global Africa captures the multiple dynamics of a globalized world and its impact on medicine, health, and the delivery of healthcare in Africa—and beyond. Essays by an international group of contributors take on intractable problems such as HIV/AIDS, malaria, and insufficient access to healthcare, drugs, resources, hospitals, and technologies. The movements of people and resources described here expose the growing challenges of poverty and public health, but they also show how new opportunities have been created for transforming healthcare and promoting care and healing.

This is an innovative investigation of pluralism in health care. Using both extensive archival material and oral histories it examines relationships between indigenous healing, missionary medicine, and 'western' biomedicine. The book includes the different regions within South Africa although focusing in most detail on the Cape, the earliest area of white settlement. In a wide-ranging survey the division in medicine between 'western' and indigenous medicine is analysed through an exploration of the evolving practices of healers, missionaries, doctors and nurses. The book considers the extent to which there was a strategic crossing of boundaries in the construction of hybrid practices by these practitioners, and the extent to which patients pursued health by sampling diverse care options. Starting with missionary penetration during the early nineteenth century, the volume outlines interventions by the colonial state in medicine and public health, and the continued resilience of indigenous healing in the face of this. The book ends by relating past to present in scrutinising the legacy of historical structures - including those of the apartheid state - for current health care, and in briefly discussing the huge challenges that the HIV/Aids pandemic poses in impacting on them. The book thus provides an inclusive history of medicine for the 'New' South Africa.

This book presents a comprehensive discussion of classical ideas, core topics, currents and detailed theoretical underpinnings in medical sociology. It is a globally renowned source and reference for those interested in social dimensions of health and illness. The presentation is enriched with explanatory and illustrative styles. The design and illustration of details will shift the minds of the readers from mere classroom discourse to societal context (the space of health issues), to consider the implications of those ideas in a way that could guide health interventions. The elemental strengths are the sociological illustrations from African context, rooted in deep cultural interpretations necessitated because Africa bears a greater brunt of health problems. More so, the classical and current epistemological and theoretical discourse presented in this book are indicative of core themes in medical sociology in particular, but cut across a multidisciplinary realm including health social sciences (e.g., medical anthropology, health psychology, medical demography, medical geography and health economics) and health studies (medicine, public health, epidemiology, bioethics and medical humanities) in general. Therefore, apart from the book’s relevance as a teaching text of medical sociology for academics, it is also meant for students at various levels and all health professionals who require a deeper understanding of social dimensions of health and illness (with illustrations from the African context) and sociological contributions to health studies in general.

This subtle and powerful ethnography examines African healing and its relationship to medical science. Stacey A. Langwick investigates the practices of healers in Tanzania who confront the most intractable illnesses in the region, including AIDS and malaria. She reveals how healers generate new therapies and shape the bodies of their patients as they address devils and parasites, anti-witchcraft medicine, and child immunization. Transcending the dualisms between tradition and science, culture and nature, belief and knowledge, Langwick tells a new story about the materiality of healing and postcolonial politics. This important work bridges postcolonial theory, science, public health, and anthropology.

In this book, Dr. John M. Janzen describes patterns of healing among the BaKongo of Lower Zaire in Africa, who, like many peoples elsewhere, utilize cosmopolitan medicine alongside traditional healing practices. What criteria, he asks, determine the choice of the alternative therapies? And what is their institutional interrelationship? In seeking answers, he analyzes case histories and cultural contexts to explore what social transactions, decisionmaking, illness and therapy classifications, and resource allocations are used in the choice of therapy by the ill, their kinfolk, friends, asociates, and specialized practitioners. From the Preface: This book presents an "on the ground" ethnographic account of how medical clients of one region of Lower Zaire diagnose illness, select therapies, and evaluate treatments, a process we call "therapy management." The book is intended to clarify a phenomenon of which central African clients have long been cognizant, namely, that medical systems are used in combination. Our study is aimed primarily at readers interested in the practical issues of medical decision-making in an African country, the cultural content of symptoms, and the dynamics of medical pluralism, that is, the existence in a single society of differently designed and conceived medical systems.