Many people regard the presence of mild ill health as a normal part of life. It is believed that people cannot always be in a very good health because of poor living conditions and the presence of spirits and witches in society. But if the [symptoms] persist and are severe, the individual is likely to enter the second stage in which he adopts the sick role.
At this stage some individuals seek professional help at once but others delay seeking medical care for as long as possible and employ known traditional drugs or patent medicines suggested by friends, neighbours, or relatives.
There are many factors which may motivate patients to delay in seeking medical care such as fear of hospitalization, one’s position in the family, fear of disturbing social relations, fear of leaving the familiar surroundings at home, past experience, financial cost of medical care, and social stigma.
Before many of the sick individuals seek professional help they make contact with others with whom they have close ties such as members of their family, friends, neighbours, workmates and employers. These people influence the slick individual in the choice of therapy and usually continue to take care of the sick person throughout his illness.[...]
Many people believe that illnesses may have either a normal or an abnormal cause. Illnesses such as coughs, slight fevers, stomachache and headaches are generally regarded as normal since they occur from time to time in the life of individuals and are usually of a fleeting nature and may disappear completely. Normal illnesses are usually treated with modern or traditional medicines. Choice of treatment in this kind of situation largely depends upon the cost of each treatment, its accessibility and the patient’s knowledge of the probable effects of each kind of treatment. Many people agree that normal illnesses are caused by such things as germs, bacteria, bad food, accidents, poisons and so on.
But when an illness such as headache persists over a long period of time it ceases to be a normal illness because it is considered unusual for a headache or a stomachache to fail to respond to treatment. The illness is then regarded as abnormal. Many people believe that social agents such as [...] spirits and witches, send such illnesses. Once an illness has been defined as abnormal most patients consult traditional healers alone because they know that modern doctors are unable to attack the ultimate cause of abnormal illness.[...]
Many people who refer their illnesses to modern practitioners later take the same illness to traditional healers. This often happens when the illness that was initially regarded as normal is redefined as abnormal by the patient and members of his or her social group.
This tendency to regard [an] illness first considered normal as abnormal exists:
a) when modern medicines fail to achieve the expected results;
b) when there is a worsening or failure of the illness to respond to treatment;
c) when there is an appearance of symptoms believed to be peculiar to Africans;
d) when there is an appearance of additional symptoms that in the light of traditional knowledge are regarded as unusual.
Many patients who choose traditional medical aid initially or witch to it eventually also seek modern medicine again. The change of therapy is more likely to occur in the following circumstances:
a) when traditional medicines fail to cure the illness;
b) when the suspicions held by the patient and his social group regarding the cause of the illness are not confirmed by traditional practitioners;
c) when the patient and his or her social group are unable to accept the traditional healers’s diagnosis;
d) when the patient and his or her social group are uncertain about the diagnosis or prognosis of the illness and are willing to try both approaches to healing;
e) when the symptoms that were initially regarded as strange or supernatural disappear.
In certain cases the same illness is refereed at different stages or simultaneously to both modern and traditional practitioners. This happens where people involved have made a distinction between medicine and practice. Many modern medicines are often better than traditional; they relieve symptoms better and faster than many traditional medicines. It is for this reason that many people now resort to modern medicines when ill.
On the question of medical practice, however, Western ideas have little in common with those found in Africa. Practices such as change of climate, exercise, and cutting down on smoking, are not generally found in African culture. On the other hand, such things as offering to placate spirits or ancestors, rubbing oneself with a chicken or goat in order to transfer the sickness to that creature, are not generally recommended by modern doctors as curative techniques. Thus, the power of modern medicines in relieving symptoms may be sought from the modern doctor, while the practices suggested by the traditional healer for relieving the basic cause of illness, plus the hope he gives the patient, may also lead the patient to him.
These facts should alert us to the possiblility that the process by which the definition of the illness is arrived at, the people making the definition and the situation in which the definition is made may all be important in understanding illness behavior.
The inclusion of spirits in a discussion of causes of illnesses often puzzles many modern medical scientists.
Spirits are unobservable objects. And because of this has no accumulated empirical knowledge. Western or modern medical science has, therefore, tried to disown this level of knowledge. Modern medicine is rooted in scientific method; illness is viewed as a natural phenomenon that can be explained in terms of physical processes and therefore curable by rational methods.
Traditional medicine has added another dimension, that is, non-scientific or subjective knowledge. They are right because medical knowledge is, in fact, produced in society of objective and subjective ways because medicine deals with human beings who exhibited both objective and subjective dimensions. Non-scientific or subjective knowledge has a place in the practice of medicine.
Psychology can help us understand one way by which spiritis can cause illnesses. People who believe in spirits can become sick and a result of this belief. They believe, for example, that ancestors can punish them if they commit certain anti-social acts. The ancestors, when offended, can punish an individual with illness and in extreme cases, with death. Thus, when people who believe in spirits commit certain anti-social acts that they believe will offend their ancestors, they may well become sick. After all, what people believe to be true is true in its consequences. Emotional shock induced by prolonged and tense emotion due to the belief that one has been attacked or is about to be attacked by spirits is often sufficient to cause illness or death.
Because these spirits are considered to be of such immense importance in the general concepts of health and illness, religious rituals and invocations, magical methods constitute integral parts of African traditional medicine and are often applied to the advantage of the patient.
Witchcraft is another major cause of illness. Many people agree that witches exist in society. On the other hand, modern science has taken the view that witches do not exist except in the minds of certain people. The difference of opinion has been caused by two main factors. There is, firstly, the absence of a shared, clear and correct definition of African witchcraft. People who take part in the witchcraft debate do not usually argue about the same thing. The second cause of conflict has been the reliance on the part of many people on the English or European literature relating to witchcraft. It is from this literature and not from personal experience or research that their ideas of witchcraft were acquired.
There are important differences between European and African witchcraft ideas. Witchcraft in Africa includes harmful medicines, harmful charms, harmful magic and any other means or devices in causing any injury to any person or animal or property. The connection between the use of certain types of harmful medicines and illnesses can easily be demonstated. Other ways such as the use of certain charms and contagious magic are more complex.
It is important, however, to bear in mind that many people who accuse others of witchcraft are not seeking a legal ruling of the matter. The accusation may be a response to situations of anxiety and stress or means for the expression of social strains and tensions. The accusation may also be a means of social control or of social rupture, or a means of adaptation to rapid and disruptive social change. These are not legal issues; they are cultural, social and psychological issues that nonetheless call for urgent attention. In other words, it is not always helpful to try and prove whether an individual accused of witchcraft is in fact a witch; it is often more useful to examine the events that led to the accusation of witchcraft and attempt to solve the social problem involved.
Many people believe that abnormal illnesses may to a certain extent be avoided or prevented by wearing charms, making the necessary offerings to the ancestors, behaving in such a way that does not make enemies, and avoiding plaes where witches may attack one. But all these measures may fail. Curative measures must then involve the use of medicines to correct the bodily condition and also rituals to remove the bad cause.
Source: Newsletter, African Traditional Herbal Research Clinic, Volume 7, Issue 11, October 2012.