scholarly journals Ancestral calling, traditional health practitioner training and mental illness: An ethnographic study from rural KwaZulu-Natal, South Africa

2020 ◽  
pp. 136346152090961
Author(s):  
Martine van der Zeijst ◽  
Wim Veling ◽  
Elliot Mqansa Makhathini ◽  
Ezra Susser ◽  
Jonathan K. Burns ◽  
...  
Keyword(s):  
South Africa ◽  
Mental Illness ◽  
Ethnographic Study ◽  
Health Practitioner ◽  
Care Clinic ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Practitioner Training ◽  
Kwazulu Natal ◽  
Health Practitioners

This qualitative ethnographic study complements an epidemiological study on first episode psychosis in Vulindlela, a rural area in KwaZulu-Natal, South Africa. It focuses on two themes that emerged from our data: (1) the calling of the ancestors to become a traditional health practitioner and (2) ukuthwasa, the training to become a traditional health practitioner. The purpose of this study is to describe the ancestral calling, and to explore whether ukuthwasa may help with the management of mental disturbances, including unusual perceptual experiences. We also provide a discussion of the changing sociopolitical context of healing in KwaZulu-Natal, as a background to our study. In-depth interviews were conducted with 20 (apprentice) traditional health practitioners, formal health practitioners, patients and relatives recruited through local traditional health practitioners and a health care clinic. Our results show that the ancestral calling might announce itself with symptoms of mental illness including unusual perceptual experiences, for which some participants consider ukuthwasa as the only effective cure. We found indications that in some individuals successful completion of ukuthwasa might promote recovery from their illness and lead to a profession in which the unusual perceptual experiences become a legitimate and positively valued aspect. We suggest that – in this particular community today, which has been subject to several sociopolitical changes – ukuthwasa may be a culturally sanctioned healing process which moderates experiences that a Western psychiatric system might characterize as psychotic symptoms, providing some individuals with a lucrative and respected role in society.

scholarly journals Core competencies acquired in indigenous training of traditional health practitioners in Kwazulu-Natal

1970 ◽  
Vol 19 (4) ◽  
pp. 3100-3106
Author(s):  
Mbatha Nompumelelo ◽  
Exnevia Gomo ◽  
Nceba Gqaleni ◽  
Mlungisi Ngcobo
Keyword(s):  
South Africa ◽  
Health Care ◽  
Spiritual Development ◽  
Urban Areas ◽  
Core Competencies ◽  
Sequential Data ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Kwazulu Natal ◽  
Health Practitioners

Introduction: Despite the recognition of Traditional Medicine systems as a critical component of health care by the WHO and the African Union, its integration into the health care mainstream remains very subdued in South Africa. This is partly due to the lack of empirical data pertinent to traditional healer training that could inform the accreditation process. Objective: To determine core competencies acquired by Traditional Health Practitioners (THP) of KwaZulu-Natal Province, South Africa during their apprenticeship. Materials and methods: Purposeful, convenient and snowballing sampling and the sequential data collection methods of questionnaires, journaling and focus groups was used to collect data from the THP tutors and their trainees in rural, peri-urban and urban areas of eThekwini and uThungulu Districts of Kwa Zulu Natal (KZN). Results: Eleven core competencies were identified: consultation, diagnoses, holistic patient care and treatment, integrative and holistic healing, application of healing procedures and cultural rituals, spiritual development, ethical competencies, problem solving, herbalism, ancestral knowledge and end of life care. Conclusion: The apprenticeship of THPs in KZN is based on eleven core competencies. These competencies are fundamental pillars for critical health care provided by THPs and are crucial for setting standards for the accreditation of traditional training in South Africa if the THP Act 22 of 2007 is to achieve its purpose of providing for the management of and control over the registration, training and conduct of the practitioners. Hence, the appointed interim THP Council should include the identified competencies when articulating bases for accreditation of the training and assessments.Keywords: Indigenous training, traditional health practitioners, Kwazulu-Natal.

scholarly journals Psychopathology among apprentice traditional health practitioners: A quantitative study from rural KwaZulu-Natal, South Africa

2020 ◽  
pp. 136346152094967
Author(s):  
Martine C.E. van der Zeijst ◽  
Wim Veling ◽  
Elliot Mqansa Makhathini ◽  
Sisanda Mtshemla ◽  
Ndukuzakhe D. Mbatha ◽  
...  
Keyword(s):  
South Africa ◽  
Psychotic Disorder ◽  
Psychiatric Symptoms ◽  
Psychotic Symptoms ◽  
Middle Income ◽  
Middle Income Countries ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Kwazulu Natal ◽  
Health Practitioners

Sociocultural context seems to influence the epidemiology, phenotype, treatment, and course of psychosis. However, data from low- and middle-income countries is sparse. This research is part of a multidisciplinary and multimethod study on possible mental disturbances, including hallucinations, among (apprentice) traditional health practitioners (THPs) who have experienced the “ancestral calling to become a THP” in rural KwaZulu-Natal, South Africa. The aim of the current article is to examine whether the calling-related experiences can be assessed according to a psychiatric taxonomy. We included individuals who were identified with the calling and who were undergoing training to become a THP ( ukuthwasa). IsiZulu-speaking formal mental health practitioners conducted thorough psychiatric interviews that measured psychological experiences with and without distress using the Community Assessment of Psychic Experiences, and psychiatric symptoms and disorders using the Schedule for Clinical Assessment in Neuropsychiatry. Of the 48 individuals who participated, 92% had psychotic experiences (PE), causing distress in 75%; and 23% met DSM-5 criteria for an unspecified psychotic disorder (15%) or mood disorder (8%). In conclusion, in rural KwaZulu-Natal, the ancestral calling may resemble phenomena that psychiatry would understand in the context of psychosis, ranging from subclinical PE to clinical psychotic disorder. Ukuthwasa might have a beneficial influence on the course of psychotic symptoms in some individuals, potentially because it reduces stigma and promotes recovery. Further multidisciplinary research is needed to investigate the psychopathology of the apprentice THPs and the underlying processes of ukuthwasa.

Knowledge and documentation of patient health information among traditional health practitioners in urban and peri-urban areas of eThekwini Municipality, KwaZulu-Natal Province, South Africa

2019 ◽  
pp. 183335831989047
Author(s):  
Tracy Zhandire ◽  
Nceba Gqaleni ◽  
Mlungisi Ngcobo ◽  
Exnevia Gomo
Keyword(s):  
South Africa ◽  
Logistic Regression ◽  
Traditional Medicine ◽  
Health Information ◽  
Traditional Health ◽  
Traditional Health Practitioners ◽  
Number Of Patients ◽  
Kwazulu Natal ◽  
Health Practitioners ◽  
Patient Health

Background: Documentation of patient health information (PHI) is a regulatory requirement and hence a standard procedure in allopathic healthcare practice. The opposite is true for African traditional medicine (ATM) in most African countries, including South Africa, despite legal and policy frameworks that recognise and mandate the institutionalisation of ATM. Developing good practice standards for PHI documentation is an essential step in the institutionalisation of ATM. Objective: This study examined the knowledge and practices of documentation of PHI by traditional health practitioners (THPs) in Durban, eThekwini Municipality, KwaZulu-Natal Province, South Africa. Methods: In this quantitative cross-sectional study, snowball sampling was used to identify and recruit THPs. An interviewer-administered questionnaire was used to gather data. Chi-square tests and logistic regression were used to assess associations of knowledge and practice of documentation of PHI with potential predictors; age, gender, education, type of practitioner, experience, number of patients seen per day and location of the practice. Results: Of the 248 THPs who participated, 71.8% were female. Mean (SD) age was 47.4 (14.2), ranging 18–81 years. The majority (65.7%) were Izangoma (diviners). Overall, 42.9% of the THPs reported knowledge of patient medical records (PMRs). In logistic regression, only number of patients seen per day remained a significant predictor of knowledge about PMR. THPs who reported seeing 6–10 patients were five times more likely (Odds Ratio (OR): 5.164, 95% Confidence Interval (CI): 1.270–20.996; p = 0.022) to report knowledge of PMR than those seeing <6 patients per day. Overall, 25.0% of THPs reported that they were documenting some PHI. Documentation was associated with having knowledge of PMR (OR: 29.323, 95% CI: 10.455–82.241; p < 0.0001) and being an Isangoma (OR: 3.251, 95% CI: 1.092–9.679; p = 0.02). Not knowing what (56.5%) and how (50.5%) to record were the most commonly cited reasons for not documenting. Conclusion: Knowledge of PMR is low, and the practice of documenting PHI is even lower among THPs in eThekwini. That knowledge of PMR was a strong predictor of documentation practice, and the most common reason for not documenting was lack of knowledge about what and how to document suggests that training could improve PHI documentation in traditional medicine practice.

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