TRADITIONAL MEDICAL BELIEFS AND PRACTICES IN URBAN CONTEXT (THE CASE OF GULELE SUB-CITY, ADDIS ABABA)

By: Yonas Yilma

Advisor: Abraham Alemu

Jun. 2011

BACKGROUND

Traditional medicine refers to any ancient, culturally based healthcare practice different from modern medicine and it is commonly regarded as indigenous, unorthodox, alternative or folk and largely orally transmitted practice used by communities with different cultures (Croizer, 1968).

From the healing practices of man, healing using traditional medicine has a long history. TM and THs possessed key positions in the society. It has been noted that about 80% of the world population were dependent of THs (WHO, 2004)

CONTN’ED

People in developing world are heavily dependent on TM. Africa is one of the continents in which TM is highly practiced. Many Africans depend on the use of TM and THs services to deal with their H.P.

TM also has a very long history in Ethiopia before the begging of MM . It has been providing both preventative and curative services for Ethiopian peoples.

CONTN’ED

Even today, various studies have shown that 90% of Ethiopians still depend on TM.

Populations in developing countries using TM for primary health care (WHO, 2004).

60% Uganda

60% Tan-

zania

70% Rwanda

70% India

70% Benin

90% Ethiopi

a

CONTN’ED

TM services are not limited to rural areas rather also has numerous roles in urban areas of the country.

This reality motivate me to focus on beliefs and practices of TM in urban contexts like in Addis Ababa, by taking the roles of THs and their treatment practice in Gulele sub-city as a case.

STATEMENT OF THE PROBLEM

In developing world in general TM has played a significant role for a long period of time. This role has continued even with the emergence and expansion of MHCF.

The majority of the African population has a limited chance of getting MHCSs (Wondwosen,

2005).

CONTN’ED Ethiopian modern health care services and

service providing institutions are not only insufficient, but also inaccessible and unaffordable to the majority of the population (Kebede, 2006:2).

Even, in urban centers, where the concentration of modern health care services and modern medicines are relatively high, THs and their services have a remarkable contribution as alternative for health care service of urban inhabitants

CONTN’ED

TM has various roles in Addis Ababa. However, in spite of its potential contributions, it has been limited in urban contexts. Most researchers were done in rural areas and many scholars often associate the term ‘traditional’ as a rural issue only.

The few researches such as, Kloos (1973), Wondossen (2004) and Neghsti (1991) discussed the different aspects of TM in Addis Ababa. Neither of these studies give special emphasis to traditional beliefs and practices of TM in urban areas in Addis Ababa.

CONTN’ED

Therefore, this study contributes to the limited literature on TM, the concept of Health, disease and illness, the causal explanation of disease and illness, treatment mechanisms by taking Gulele sub-city of Addis Ababa as the study population.

OBJECTIVES

General Objective The general objective of this study was to investigate and

document beliefs and practices of traditional medicine in Gulele sub-city.

Specific Objectives To identify patients’ and healers views about the causes of

disease; To explore the main clients of traditional healers and the

reasons they visit them; To assess the relations and potential interactions between

traditional healers and their clients, traditional healers and modern medical system;

To assess patients’ concept of health, illness, and disease.; and

To investigate the roles that healers play in the study area.

METHODS AND METHODOLOGY

Study Area Addis Ababa is currently divided to ten sub

cities.Gulele sub city one of the sub city. It has boundaries form the south east with Yeka, form the south west with kolfe Keranyo, form the south Addis Ketema and Arada Sub city.

RESEARCH APPROACH

Both quantitative and qualitative approaches were utilized in this study.

The quantitative approach was found to be appropriate since the study was interested to investigate the diversity among clients. It is used to answer questions like ‘which age group predominantly utilizes traditional medicine?’

Qualitative approach allows to understand the meanings actors attach to their actions and experiences. it is the most appropriate approach in investigating the experiences of clients with traditional medicine.

RESEARCH METHODS

The study triangulated the methods of survey research, life history, and oral history interview.

life history interview- this method was used to collect data about the biography of the healers.

oral history interview- this method was employed for five clients cases. It was employed to make clients reflect upon specific events or periods in the past

SAMPLING TECHNIQUES

Three traditional healing centers were purposively selected based on: The healer should have a widespread fame The healing center should be visited by

multitude of clients. Finally, healers should have their own healing

center with some sort of advertisement.

CONTN’ED

Non-probability technique of convenient sampling was used to select clients. Because it was found impossible to get a readily available list of the population..

Besides, five cases which reflect the communality among 52 clients were drawn purposively.

Finally, Six informants who are working in modern health care professionals were selected

INSTRUMENTS OF DATA COLLECTION

Questionnaire: A semi-structured questionnaire was prepared and administered to 52 clients of traditional healing centers.

Interviews: In-depth interviews were carried out with three traditional healers, five clients and six modern health care professionals.

Observations: regarding the issue at hand including diagnostic procedures, drug administrations and the general interactions between the traditional healers and their clients.

Document Analysis: Written patient witnesses which were documented in one healing centers were analyzed.

METHODS OF DATA ANALYSIS

The quantitative data collected through questionnaire were analyzed using simple descriptive statistics. They were organized in table format and described in frequency and percentage.

On the other hand, the qualitative data which were the backbone of the study were analyzed using narrative analysis.

MAJOR FINDINGS People in the study area perceived health as ability

to gain what a person wants to get, balanced relationship between man and man; man and nature; man and the supernatural world; ability to perform day to day activities and responsibilities; leading good life and the absence of diseases and illness. Hence, more of cultural rather than WHO definition and conception of health is reflected in the study area.

CONTN’ED There are some differences in beliefs between the

traditional healers and patients regarding the immediate causes of health problems.

-the majority of Patients the cause of health problems associated with the supernatural/God/ as the main source of illness

-The traditional healers claimed natural agents as causes of health problems.

-

CONTN’ED The clients of healers in the study area are diversified in

sex, religious background and educational level. The clients of the healers are multi ethnic TM

everywhere though there is difference in ethnic background.

Youngster and middle-age people constitute a great proportion of the user of THs treatments

For the majority of the clients utilize traditional medicine as a method of last resort . The shift is mainly motivated by lack of the desired results and/or shortage of money to continue with their first therapeutic option.

All the respondents included in the survey support the promotion of traditional medical services at the side of modern medicine

CONTN’ED THs in the study area have a positive attitude

towards MMHCS. In contrast, MMP negative attitude towards THs The common diseases within the study area

affect external body parts, especially the skin. These skin disorder diseases are treatable by

the sub city healers using common medicinal plants found in different parts of the country.

HAKIM TEKLE TREATING A PATIENT SUFFERING FROM CHIFIE (ECZEMA)

CONTN’ED Plant products (roots, leaves, barks and lemon, ),

animal products (butter, honey, oil, animal fat) and Water, sugar, salt and milk used as solvents in preparation of liquid drugs are found to be the main source of the medicines prepared by the sub-city healers.

CONTN’ED

The way to administer herbal medicine by healers varies according to dosage, forms and their intended purpose. Ex- powder and ointment for skin disease, liquid form used for Diarrhea and inhalation form is also use asthma

Plant or herbal medicines is the most frequent means of treatment.

CONTN’ED

The role of Tm in the study area THs and the their clients have intimate

relationships Saving time The effectiveness of medicine on some disease Fairly negotiable payment

CONCLUSION

Traditional medicine practice has been playing a pivotal role in the Gulele sub city. Healers whom I met have an intimate knowledge about plants and preparation of herbal medicines from the steam, leaf, roots and/or flowers of plants to use them to cure different human ailments.

The present study also demonstrated that most of the healers do not grow medicinal plants in their garden. Traditional medicinal plants were collected mostly from natural vegetation area specially desert area of the country.

CONTN’ED Acquisition of their knowledge about the use of

medicinal plants and other traditional medical practices mainly from their relative and supernatural power. This indicates that the knowledge is mainly transmitted through word of mouth from parents and traditional healers to their successors.

Diseases which are believed to be effectively treated by locale healers than professionals. These include Kintarot,Yewef Beshita(Jaundice), Chefie, Almaz Balechera, Epilepsy, Skin Cancer etc.

CONTN’ED

The clients of healers are multiethnic. This is clear indicator of the fact that there is a need for traditional medicine everywhere though there is difference in ethnic background.

Traditional medical practices are condemned by MHCPs working in MHCI as backward, superstitious, irrational and dangerous.

RECOMMENDATIONS

Integrating TM and MM is very important for effective treatment service

GSCHO should encourage healers to record the prescriptions of medical plants which have been proved to cure different ailments.

Conserving medicinal plants for various purposes can be achieved by encouraging people to grow them and by establishing local medicinal plants gardens in the sub city.

The MOH should have the will to reconcile the two systems for integration. The integration of traditional and modern medicine emphasizes the importance of respectful co-existence.

ACKNOWLEDGEMENTS

My advisor Abraham Alemu Participants of this study AAU

THANK YOU