Crosscultural perceptions traditional culturally specific interventions

1
Cross-cultural perceptions traditional/
culturally specific interventions

• Traditional Healers

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Why Work with Traditional Healers?

• High of forced migrants who believe in and
  utilize traditional healers (both for cultural
  reasons, and perhaps partially due to limited
  access to other types of medical support
  services).

3
UN Manuals emphasize the importance of working
with traditional healers

• World Health Organization (1996). Mental health
  of refugees. Traditional Medicine and Traditional
  Healers Unit 6, pgs 89-100.
• UNAIDS (2000). Collaboration with traditional
  healers in HIV/AIDS prevention and care.

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Types of Common Traditional Healers

• 1. Plant prescriptions for symptom tx
• 2. Trance-induced advice from spirits
• 3. Shaman soul return
• 4. Magical protection/ counteracting black magic
  (evil eye, voodoo, hexes)
• 5. Fortune tellers
• 6. Massage practitioners (acupuncture,
  reflexology, reiki, etc).

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Some examples of traditional interventions

• Exorcisms with trance components
• Cleansing/rebirth ceremonies
• Offering to the gods on behalf of the person
  suffering
• Prayer circles and spontaneous healing
• Elder council
• Magic ceremonies
• Council with deceased ancestors or spirits.

Note some of the above may also involve herbal
remedies, monetary or other exchange, animal
sacrifice, etc.
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Traditional Healers Iran

• Asefzadeh, S. and Sameefar F. (2001). Traditional
  healers in the Qazvin region of the Islamic
  Republic of Iran a qualitative study. Eastern
  Mediterranean Health Journal, Volume 7, No. 3,
  544-551.

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Origin of the Zar

• The Zar is an ancient "trance dance" which most
  scholars agree originated in the Sudan.
• From there its practice spread to many regions
  including ancient Egypt. Over time, each group of
  people practicing the Zar added their own
  interpretations and methods.

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ZAR RITUALS
The zar is a ritual used to perform a cathartic
sort of emotional healing or "exorcism" on behalf
of someone, usually a woman, who has been
possessed. The Zar is an ancient form of
purification rite. It is meant to pacify spirits
and to harmonize the inner lives of the
participants with them. The accompaniment to the
zar consists of strong drum rhythms, each being
specific to a certain spirit.
A critical part of the zar is finding the rhythm
required to drive out the particular spirit
possessing the individual.
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Where is it practiced?

• Although technically forbidden by Islam
  (primarily Islamic religious leaders in Egypt and
  Sudan), it continues to be an essential part of
  some cultures.
• It appears mostly in Egypt, Sudan, Somalia, and
  Ethiopia.

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Sometimes the zar leader sacrifices a chicken,
pigeon, sheep, or other animal as part of the
ritual.
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The role of women in Zar

• Zar is one of the few still existing ancient
  healing ceremonies performed mainly by women for
  women.
• The Zar is one of the rare musical traditions in
  which women play the leading role.
• The ritual is lead by a woman called kudeyit.

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And the role of Zar in healing women

• Researchers have suggested that these kind of
  ancient healing rituals are most popular among
  women as they constitute one of the few accepted
  venues for them to release pent up emotions and
  frustrations while consciously seeking healing
  powers.
• Particularly for women in socially subordinate
  positions, possession often forms a therapeutic
  escape valve.

13
Traditional healers in Tanzania are typically
inducted through one of four routes
1. Inheritance within a family kinship 2.
Ancestor-spirits (midzimu) contacted through
dreams 3. The experience of having an illness
cured by traditional medicine 4. A personal
decision, followed by a period of apprenticeship.
In 1995 Tanzanian traditional healers formed
an association called CHAWATIATA (the Tanzania
Traditional Health Practitioners Association).
14
Traditional medicine In South Africa is utilized
by an estimated 80 of the Black Population
The theory underlying traditional medicine in the
several black ethnic groups of South Africa is
essentially as follows Disease is a
supernatural phenomenon governed by a hierarchy
of vital powers beginning with a most powerful
deity followed by lesser spiritual entities,
ancestral spirits, living persons, animals,
plants, and other objects. These powers can
interact, and they can reduce or enhance the
power of a person. Disharmony in these vital
powers can cause illness. Thus, ancestral spirits
can make a person ill.
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Traditional Healers in India Ayurvedic Medicine
Traditional systems of medicine are widely
practiced in other areas beyond the African
continent. For example, India runs hospitals
that offer ayurvedic treatment and conduct formal
university courses in ayurvedic medicine. One
such course leads to the Bachelor of Ayurvedic
Medicine and Surgery (BAMS) degree. Graduates
often set up general practice and dispense
natural medicines.
16
Italy Religious Healing
In Italy a religious group called Renewal in the
Spirit, counts almost three hundred thousand
faithful who gather for religious healing
purposes. The healing is lead by animators who,
upon completion of a long spiritual journey
within the community, have the following gifts
(charisma), which are specific to charismatic
prayer prophecy, the gift of language, the
gift of interpretation, the language of knowledge
and science, discernment, and healing.
17
Traditional Healing of Indigenous Populations in
the Americas

• Indigenous Peoples mental health initiatives
  seem to favor the collaboration of healers and
  doctors as a key element for building culturally
  appropriate mental health services for Amerindian
  communities.
• Jambihuasi is an innovative health care service
  in the Andes that combines Quichua traditional
  medicine with Western medicine, and enjoys broad
  acceptance by Quichua communities.

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Pros and cons of traditional healing systems

• Case 1 A young Nepalese girl is sold to a local
  Hindu temple (married to the god), and is
  considered as sacred from this point forward.
• Men who are HIV have been told by the temple
  priest that if they have sex with the girl she
  will cure their HIVa local man has sex with
  her, and formerly suicidally depressed,
  afterwards he reports feeling much more
  optimistic about the future, confident that he
  will be now be cured.

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Pros and cons of traditional healing systems

• Case 2 the family of a woman with symptoms of
  psychosis (incoherent thoughts, hallucinations,
  etc) following a rape hires a local shaman to
  exorcise the demons through an elaborate ceremony
  following which she sleeps for a full day and
  then wakes up seemingly fully recovered. The
  family rejoices and she is accepted back into
  society.
• Case 3 Another woman in the same community
  undergoes a similar ceremony and emerges severely
  frightened and seemingly much worse than before.

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Pros and cons of traditional healing systems

• Case 4 A former child soldier in Liberia is
  ostracized by the community out of fear that he
  has been corrupted by his experience of having
  been kidnapped, drugged and trained to kill. He
  lives at a local shelter run by an NGO and is not
  even visited by his family. A local healer comes
  to the shelter to perform a cleansing ceremony,
  sacrificing a chicken in the process and rubbing
  the blood all over the boys body.
• Following this his family begins visiting him
  regularly and eventually allows him back home.

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Small group discussion

• 1. Can you think of examples from your own
  culture (or work experiences) of traditional
  healing systems?
• 2. Examine your own cultural and religious biases
  (we all have them). Will it be difficult for you
  to collaborate with some types of traditional
  healers?

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Some Traditional Healers use the Tactics
below Are these compatible with your value
system?
Physical force (of any kind) Scare
tactics Family consent but no explicit
individual consent Animal sacrifice Smearing
urine or feces on the body Accusing someone of
misdeeds or being polluted/ needing the person to
agree to this premise first, as a prerequisite to
healing them.
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Some Biomedical Healers use the Tactics below

• Can you imagine how these might not be compatible
  with someones value system?
• Sticking people with needles
• Cutting people open/ interacting with organs or
  transplanting the organs from one person into
  another
• Radiating people, making them sick in order to
  make them better

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Large Group Discussion

• 1. What are some of the benefits of becoming
  knowledgeable re the traditional beliefs and
  approaches of other cultures?
• 2. How do controversial or dangerous traditional
  practices compare with potentially damaging
  practices from a more Western cultural medical
  approach?
• 3. Is it possible to combine the best elements of
  both and create hybrid interventions, or are
  the ideals incompatible as some suggest?