Health seeking behavior and use of medicinal plants among the Hamer ethnic group,South Omo zone,southwestern Ethiopia

Background

Health seeking behavior of people around the globe is affected by different socio-cultural and economic factors. In Ethiopia, people living in rural areas in particular, are noted for their use of medicinal plants as a major component of their health care option. This study was conducted to document ethnopharmacological information of the Hamer semi-pastoralists ethnic group in southwestern Ethiopia.

Methods

A cross-sectional study was carried out whereby information on demographic characteristics, prevalence of perceived illnesses, factors associated with preference of health care seeking options, medicinal plants used and hoarded as well as some healers’ socio-economic characteristics were collected using two sets of semi-structured questionnaires – one for household (HH) heads and the other for traditional healers supplemented by focus group discussions (FGDs). Households were selected using a cluster sampling followed by systematic sampling techniques; whereas healers and FGD participants were purposively selected with the assistance of local leaders and elders from the community.

Results

The study revealed that the use of traditional medicine among the Hamer ethnic group is very high. Females preferred traditional medicine more than males. The main reasons for this preference include effectiveness, low cost and ease of availability. Malaria (gebeze) was the most frequently occurring illness in the area identified by all FGD participants. A total of 60 different medicinal plants were reported [34 by HH respondents, 14 by traditional healers and 12 by both]. Fifty-one medicinal plants were fully identified, 3 at generic level and 6 have not yet been identified.

Conclusion

It can be concluded that traditional medical practices, particularly herbal aspect, is widely used by the Hamer ethnic group, although health seeking behavior of the community is affected by different socio-economic and cultural factors.

     

Healing across Cultures: Learning from Traditions

The health and wellness of an individual are reliant on the integrated effects of mind, body, and spirit. This triad is intricately set within a backdrop of the environment, our earth. Western cultures often disregard this holism, especially this fourth component, in its considerations of wellness as described by modern medicine. This practice is unlike that of many of the traditional cultures in the world. These cultures focus more on balance in the context of environmental respect. Varied cultures share remarkable similarities in their healing modalities, especially considering the relative isolation from one to another—evidence that there is truth to the healing knowledge they possess. We are not disconnected from the natural world in terms of health, but dependent and interconnected within ourselves and to everything around us. Social change is required to assure that the practice of modern medicine evolves to incorporate this integral aspect of health and wellness, and this can be done through partnerships with traditional healers.There is a growing demand for wellness and earthly responsibility. It is time to appropriately learn from age-old societies and their healing traditions for they do have answers we are seeking in sustainability and harmony, environmental stewardship and planetary respect, and holistic health. For thousands of years, our ancestors have known the secrets of long life—this knowledge needs to be preserved through the apprenticeship of future generations. We propose a collaboration that develops mutually beneficial learning partnerships combining modern medical knowledge with the wisdom of traditional healers around the world.     

Traditional medicinal plant knowledge and use by local healers in Sekoru District, Jimma Zone, Southwestern Ethiopia

The knowledge and use of medicinal plant species by traditional healers was investigated in Sekoru District, Jimma Zone, Southwestern Ethiopia from December 2005 to November 2006. Traditional healers of the study area were selected randomly and interviewed with the help of translators to gather information on the knowledge and use of medicinal plants used as a remedy for human ailments in the study area. In the current study, it was reported that 27 plant species belonging to 27 genera and 18 families were commonly used to treat various human ailments. Most of these species (85.71%) were wild and harvested mainly for their leaves (64.52%). The most cited ethnomedicinal plant species wasAlysicarpus quartinianus A. Rich., whose roots and leaves were reported by traditional healers to be crushed in fresh and applied as a lotion on the lesions of patients ofAbiato (Shererit). No significant correlation was observed between the age of traditional healers and the number of species reported and the indigenous knowledge transfer was found to be similar. More than one medicinal plant species were used more frequently than the use of a single species for remedy preparations. Plant parts used for remedy preparations showed significant difference with medicinal plant species abundance in the study area.     

Willing the Spirits to Reveal Themselves: Rural Kenyan Mothers' Responsibility to Restore Their Children's Health

Women's contributions to the improvement and maintenance of health are being acknowledged the world over. Recent studies show that most health care is domestic and that women provide nearly 95 percent of this care. Their role as healers, nurses, doctors, folk practitioners, and lay therapists has also been recognized. This research report analyses exorcism as a special function performed by Duruma mothers on behalf of their ailing children. The women represent their children and identify the spirit(s) responsible for illnesses. This role is based on Duruma recognition of the close relationship between mothers and their children, specifically through pregnancy, lactation, and daily contact. For local people who believe in the spirit world, mothers' spirits are held to be responsible for exorcising children's illnesses. Thus health production by Duruma women goes a step further than that of women in other communities. [mothers, childhood illnesses, traditional healing, Duruma, Kenya]     

Results of delayed treatment of patients with malignant tumors of the lymphatic system]

The causes, with considerably influence the advancement of cancer process have been investigated in patients with lymphatic system tumours admitted to the Department of Chemotherapy at the Center of Oncology in Cracow. It has been revealed, that the delay in the treatment was mainly due to false first diagnosis as well as the negligence of the symptoms by the patients themselves and also to consulting medically unrecognized "healers" before undertaking proper, specialized treatment. It has been observed, that more than every fourth patient took advice of "non-doctors", i.e. bioenergy-therapists, incompetent healers, herbalists and so forth. These factors by influencing further delay in the treatment, diminish its chances.     

Circle of healing: traditional storytelling, part three

Southcentral Foundation had to overcome several organizational and procedural hurdles when developing their Circle of Healing program. Among these hurdles was finding a way to credential Alaska Native healers so the Foundation could be reimbursed for their services and pay the healers, and so the healers could work in the hospital along with the staff delivering Western and alternative medical treatment. Southcentral Foundation chose to develop a process for certifying Alaska Native healers as tribal doctors. Rita Blumenstein is the first such person to be certified. Lisa Dolchok is the second. An important strength of Lisa’s presentation is that she helps us broaden our understanding of healing from an Alaska Native perspective. So often we equate healing with curing, and while it can have this dimension, Lisa reminds us there is much more to it. She echoes LouAnn Benson’s presentation in asserting that healing can address illness of the spirit or wounds to the soul.     

African independent churches in Mozambique: healing the afflictions of inequality

The recent explosive proliferation of African Independent Churches (AICs) in central Mozambique coincided with rapid growth of economic disparity in the 1990s produced by privatization, cuts in government services, and arrival of foreign aid promoted by Mozambique's World Bank/International Monetary Fund Structural Adjustment Program. Drawing on ethnographic research in the city of Chimoio, this article argues that growing inequality has led to declining social cohesion, heightened individual competition, fear of interpersonal violence, and intensified conflict between spouses in poor families. This perilous social environment finds expression in heightened fears of witchcraft, sorcery, and avenging spirits, which are often blamed in Shona ideology for reproductive health problems. Many women with sick children or suffering from infertility turn to AICs for treatment because traditional healers are increasingly viewed as dangerous and too expensive. The AICs invoke the "Holy Spirit" to exercise malevolent agents and then provide a community of mutual aid and ongoing protection against spirit threats.     

Children's traditional ecological knowledge of wild food resources: a case study in a rural village in Northeast Thailand

An ethnobotanical study was conducted from October 2005 to June 2006 to investigate the uses of medicinal plants by people in Zegie Peninsula, northwestern Ethiopia. Information was gathered from 200 people: 70 female and 130 males, using semistructured questionnaire. Of which, six were male local healers. The informants, except the healers, were selected randomly and no appointment was made prior to the visits. Informant consensus factor (ICF) for category of aliments and the fidelity level (FL) of the medicinal plants were determined. Sixty-seven medicinal plants used as a cure for 52 aliments were documented. They are distributed across 42 families and 64 genera. The most frequently utilized plant part was the underground part (root/rhizome/bulb) (42%). The largest number of remedies was used to treat gastrointestinal disorder and parasites infections (22.8%) followed by external injuries and parasites infections (22.1%). The administration routes are oral (51.4%), external (38.6%), nasal (7.9%), and ear (2.1%). The medicinal plants that were presumed to be effective in treating a certain category of disease, such as 'mich' and febrile diseases (0.80) had higher ICF values. This probably indicates a high incidence of these types of diseases in the region, possibly due to the poor socio-economic and sanitary conditions of this people. The medicinal plants that are widely used by the local people or used as a remedy for a specific aliment have higher FL values (Carissa spinarum, Clausena anisata, Acokanthera schimperi, Calpurnia aurea, Ficus thonningii, and Cyphostemma junceum) than those that are less popular or used to treat more than one type of aliments (Plumbago zeylanicum, Dorstenia barnimiana).     

Urban Philippine healers and their contrasting clienteles

This paper is concerned with medical pluralism in a Philippine setting. It reports on results of a study of four indigenous healers and their patients in Cebu City. The city is a modern medical center in the Philippines, with more than 500 practicing physicians. But its indigenous healers also treat numerous patients, and many patients utilize both physicians and healers during the course of an illness. Of the four healers discussed in this paper, two had the largest followings of any healers in the city at the time of the study, the other two had very modest practices. Significant social and medical contrasts between the clienteles of these healers are described in the paper, and the implications of these differences are discussed with respect to decisions people make about their health care in an area with diverse medical resourses.     

Improved HIV Awareness and Perceived Empowerment to Negotiate Safe Sex among Married Women in Ethiopia between 2005 and 2011

Introduction

The HIV prevalence rate in Ethiopia for married (or cohabiting) women is 3 times that found amongst women who have never been married. While marriage used to be seen as a protective factor against HIV, evidence suggests that this is no longer necessarily the case. This study analyses the trend and socio-demographic determinants of HIV awareness and safe sex negotiation among married women in Ethiopia between 2005 and 2011.

Methods

Data from Ethiopian Demographic and Health Surveys conducted in 2005 and in 2011 were analysed. Socio-demographic variables as well as ‘survey year’ were selected to assess their interaction with selected HIV awareness and safe sex negotiation indicators. Multivariable regression analyses were performed. Odds ratios and confidence intervals were computed.

Results

A significant increase in knowledge of HIV and ability to negotiate safer sex occurred between 2005 and 2011 reflecting a positive trend in gender empowerment amongst married Ethiopian women. Some of these advancements were striking, for instance respondents were 3.6 times more likely to have “Heard of AIDS” in 2011 than in 2005. HIV awareness and safer sex negotiation were significantly associated with higher education, higher socioeconomic status, those who had heard of HIV, those of the Orthodox Christian faith, and (to some extent) those living in rural areas.

Conclusion

HIV awareness has increased significantly in Ethiopia over the last decade but married women are still disproportionately susceptible to HIV. Community programmes, already effective in Ethiopia, also need to target this vulnerable sub-group of women.     

Community Health Seeking Behavior for Suspected Human and Animal Rabies Cases,Gomma District,Southwest Ethiopia

Background

Timely presentation to appropriate health service provider of sick animals/humans from zoonotic diseases like rabies is important for early case/outbreak detection and management. However, data on community’s health seeking practice for rabies in Ethiopia is limited. Therefore the objective of this study was to determine community’s health seeking behavior on rabies, Southwest Ethiopia.

Methods

A cross-sectional survey was conducted from January 16-February 14, 2015 to collect data from 808 respondents where the respondents were selected using multistage sampling technique. Data were collected using interviewer administered structured questionnaire by trained epidemiology graduate level students. Data were entered to Epidata version 3.1 and analyzed using SPSS version 20 for windows.

Result

Eight hundred three (99.4%) respondents participated in the study. Out of 28 respondents who reported their family members’ exposure to rabies, 8 of them replied that the exposed family members sought treatment from traditional healers. More than nine in ten respondents perceived that humans and domestic animals with rabies exposure should seek help of which 85% of them suggested modern health care facilities as the preferred management option for the sick humans and domestic animals. However, among those who reported sick domestic animals, near to 72% of them had either slaughtered for human consumption, sold immediately, visited traditional healer, given home care or did nothing for the sick domestic animals.

Conclusion

Majority of the respondents had favorable perception of seeking treatment from modern health care facilities for rabies. However, significant number of them had managed inappropriately for the sick domestic animals from rabies. Hence, raising awareness of the community about management of sick domestic animals from rabies and the need for reporting to both human and animal health service providers is needed.     

Sociocultural Aspects of Tuberculosis Control in Ethiopia

This article examines ethnomedical knowledge and practices related to tuberculosis conceptualization and management in a rural southern Ethiopian community. An adult health-status survey, administered to 217 adults selected through quota sampling procedures, investigated prevailing nosological structures. Additionally, disease-enhancing behaviors were identified through qualitative-research methods. The findings show that while symptomatological concepts coincide with biomedicine, the local etiological model postulates empirically based causational factors unrelated to tubercle bacilli. Therapeutic preference hinges on the utilization of ethnobotanical remedies and their expected emetic effects. The relevance of tuberculosis-related ethnomedical knowledge and management practices is discussed in relation to primary health care and diseasecontrol programs in Ethiopia. It is recommended that health-education interventions, illustrating the nature and transmission avenues of tuberculosis and the effects ofbiomedical therapies, precede and/or accompany vaccination campaigns or chemotherapy. Teaching materials should valorize existing ethnomedical notions that emphasize contagion as an avenue of disease transmission, and the importance of nutritional adequacy in fighting the disease, [tuberculosis, ethnomedical knowledge, primary health care, Ethiopia]     

Dog Demography,Animal Bite Management and Rabies Knowledge-Attitude and Practices in the Awash Basin,Eastern Ethiopia

Background

Rabies is a viral zoonosis that has been described in limited numbers of studies in Ethiopia at large and among pastoralists in particular. This study assessed dog demography, bite wound prevalence and management, potential risk factors of disease transmission and knowledge attitude practice towards rabies among urban dwellers, pastoralists and health workers in Awash, Eastern Ethiopia.

Methodology

Information was collected by means of structured questionnaires and interviews and through medical and official records from the Agricultural and Health bureaus.

Principal Findings

Respondents totaled 539 (471 urban, 49 pastoralists, 19 medical). Dog(s) were owned in 33% urban and 75.5% pastoralist households respectively. Mean dog number per dog owning household was 1.50 (95%CI: 1.40–1.60) in urban and 2.05 (95%CI: 1.51–2.60) in pastoralists sites. Human Dog Ratio in Metahara was 4.7:1. No bite wounds records were kept in medical facilities, where staff recalled around 100 bites per year, 2/3 being in adults. Over 90% of the respondents claimed knowing rabies but up to 79.2% pastoralist did not know how dogs acquire the disease; 37.3% urban and 23% pastoralist did not know the symptoms of rabies in dogs; 36% urban and 44% pastoralists did not know rabies symptoms in people. Eighty percent of pastoralists did not know that the disease was fatal in people if untreated. Over half (58.7%) of pastoralist respondents go to traditional healers if bitten, despite a health extension worker program in place in the study area. Knowledge gaps were also shown amidst medical staff.

Conclusions

The study highlighted overall poor disease knowledge, severe under-reporting of human rabies cases, lack of record keeping and poor collaboration between the public and animal health sectors and communities in rabies control.     

Educational Intervention Increased Referrals to Allopathic Care by Traditional Healers in Three High HIV-Prevalence Rural Districts in Mozambique

Introduction

Delayed uptake of clinical services impedes favorable clinical outcomes in Mozambique. Care is delayed among patients who initiate care with traditional healers; patients with conditions like human immunodeficiency virus (HIV) or tuberculosis are rarely referred to the health system in a timely fashion.

Methods

We conducted a pre-post educational intervention with traditional healers, assessing healer referral rates and HIV knowledge in three rural districts in Zambézia Province.

Results

The median monthly referral rate prior to the intervention was 0.25 patients (interquartile range [IQR]: 0–0.54) compared with a post-intervention rate of 0.34 patients (IQR: 0–0.71), a 35% increase (p = 0.046). A median HIV knowledge score of 67% (IQR: 59–78) was noted 4-months pre-intervention and a median score of 81% (IQR: 74–89) was recorded 2½ months post-intervention (p<0.001). One hundred and eleven healers referred 127 adults, 36 pregnant women, and 188 children to health facilities. Referred patients were most likely to be diagnosed with bronchopneumonia (20% adults; 13% children) and/or malaria (15% adults; 37% children). Of 315 non-pregnant persons referred, 3.5% were tested for HIV and 2.5% were tested for tuberculosis.

Discussion

We engaged traditional healers with some success; referral rates were low, but increased post-intervention. Once seen in the clinics, patients were rarely tested for HIV or tuberculosis, though symptoms suggested screening was indicated. We found increased referral rates through an inexpensive intervention with traditional healers, a viable, cost-effective method of directing patients to health facilities. However, quality improvement within the clinics is necessary before a substantial impact can be expected.     

Spirits and spiritist therapy in Southern Brazil: A case study of an innovative,syncretic healing group

This paper examines the treatment of patients by a group of Spiritist healers in southern Brazil. After describing and analyzing a healing session, the practices are shown to be deviant from conventional Spiritism in two directions: (1) they employ a technique, called apometry, that they claim makes possible the transportation of a part of the patient's body to the astral world where it is treated by disincarnate doctors who do past life regressions; and (2) although a conventional Spiritist disobsession is performed, the healers invoke rival Afro-Brazilian spirits who often are shown to have caused the patient's symptoms.Building on the work of Csordas (1983), 1 hypothesize that the discourse employed by the healers moves the patient to a new reality or phenomenological world in which s/he is healed not in the sense of being restored to the state in which s/he existed prior to the onset of illness, but in the sense of being rhetorically moved into a state dissimilar from both pre-illness and illness reality... (Csordas 1983:346). The new state, in this case, is the world of Spiritism. Unlike the Catholic Pentecostals Csordas studied who already were members of a primary group of believers, however, the patients treated by the Brazilian healers are mostly unaffiliated individuals who face the increasing uncertainty and insecurity of life in disorganized, anomic, urban Brazil. By encompassing modern science on the one hand, and aspects of the Afro-Brazilian traditions on the other, this healing group appeals to the often distraught white middle and lower-middle classes, providing them with therapeutic meaning that in many cases leads to healing, conversion, and the sense of security and safety that often accompanies identifying with and belonging to a religious group.     

Notes about the uses of plants by one of the last healers in the Basilicata Region (South Italy)

ABSTRACT: BACKGROUND: The paper refers to the knowledge and uses of plants and to the linked ritual practices as referred by Matteo (It.'Zi Matteo', En. 'Uncle Matthew'), one of the last elder healers in the Basilicata Region (South Italy). Particular attention is also paid to the uses of 'Vruca' (Tamarix gallica L.) as a medicinal and magical plant used to heal common warts on various parts of the body. METHODS: After obtaining prior informed consent, we collected data through an open interview about the uses of the plants and on the associated ritual practices. For each species, data were collected that included the vernacular names, preparation, plant parts utilized and their method of use. RESULTS: The uses of 52 taxa are described. Among these, 43 are or were employed medicinally, eight as culinary foodstuffs, and 4 for domestic, handicraft or ethnoveterinary uses. Among the major findings: the ritual and magical use of Tamarix gallica L. to heal warts is described in detail; so far, no records of similar use were found in any Italian ethnobotanical studies conducted in southern Italy. CONCLUSION: Phytotherapy in the Basilicata region is practiced by elderly people who resort to medicinal plants for mild illnesses; we interviewed one of those traditional healers who is very experienced in the field, and possesses rich ethno-pharmacological knowledge.     

Medicinal plants used by latino healers for women’s health conditions in New York City

This paper examines the use of medicinal plants by Latino healers in New York City to treat various women’s illnesses. Eight Latino healers collaborated on the study through consultations with female patients who had one of the following conditions as diagnosed by biomedically trained physicians: uterine fibroids, hot flashes, menorrhagia, or endometriosis. The study identified a total of 67 plant species prescribed by the healers in the form of mixtures or as individual plants. Voucher specimens were collected from local botánicas and identified by specialists at The New York Botanical Garden. Studies of immigrant traditional healers and the plants they use in an urban setting can provide interesting ethnobotanical data and information to assist in diagnosing conditions and contributing to treatment of patients from Latino as well as non-Latino communities.     

Extending the temporal context of ethnobotanical databases: the case study of the Campania region (southern Italy)

Background

Medicinal plants are the integral part of the variety of cultures in Ethiopia and have been used over many centuries. Hence, the aim of this study is to document the medicinal plants in the natural vegetation and home gardens in Wonago Woreda, Gedeo Zone, Southern Nations, Nationalities and Peoples Regional State (SNNPR).

Materials and methods

Thirty healers were selected to collect data on management of medicinal plants using semi-structured interview, group discussion, and field observation. The distribution of plant species in the study areas was surveyed, and preference ranking, direct matrix ranking, priority ranking of factors and Informant consensus factor (ICF) were calculated.

Results

The informants categorized the vegetation into five community types based on plant density and associated landform: 'Raqqa', 'Hakka cadanaba', 'Mancchha', 'Bullukko', and 'Wodae gido'. 155 plant species were collected from the natural vegetation and 65 plant species from the home gardens ('Gattae Oduma'). Seventy-two plant species were documented as having medicinal value: Sixty-five (71%) from natural vegetation and 27 (29%) from home gardens. Forty-five (62%) were used for humans, 15(21%) for livestock and 13(18%) for treating both human and livestock ailments: 35 (43.2%) were Shrubs, 28(34.5%) herbs, 17 (20.9%) trees and 1(1.2%) climbers. The root (35.8%) was the most commonly used plant part. The category: malaria, fever and headache had the highest 0.82 ICF. Agricultural expansion (24.4%) in the area was found to be the main threat for medicinal plants followed by fire wood collection (18.8%). Peoples' culture and spiritual beliefs somehow helped in the conservation of medicinal plants.

Conclusion

Traditional healers still depend largely on naturally growing plant species and the important medicinal plants are under threat. The documented medicinal plants can serve as a basis for further studies on the regions medicinal plants knowledge and for future phytochemical and pharmacological studies.     

Knowledge and practice of traditional healers in oral health in the Bui Division, Cameroon

Background

The extraction of the teeth by traditional healers in Cameroon is an established cultural practice in the central region of the Cameroon. Traditional healers (TH) use herbs and crude un-sterilized instruments and tools for the tooth extraction procedure. The present study investigates the knowledge and practices of traditional healers regarding tooth extraction and the management of its complications.

Methods

A cross sectional design utilizing semi-structured questionnaires was used to collect the data from traditional healers and their patients.

Results

Sixteen traditional healers (TH) were interviewed. All were male and the majority were between 25-35 years old. The most important reason given for the removal of a tooth was "if it has a hole". All reported using herbs to control bleeding and pain after extractions. Only 20% used gloves between patients when extracting a tooth and just over a third (31.3%) gave post-operative instructions. Eighty seven percent managed complications with herbs and 62.5% reported that they would refer their patients to a dentist whenever there are complications. Only a third (31.3%) was familiar with the basic anatomy of a tooth and more than half (56.3%) reported that tooth extractions are the only treatment for dental problems. One hundred and fifty patients were interviewed with a mean age of 29 years. More than two thirds were in the 21-30 year age group and just over half were male. Sixty six percent reported that they visited the TH because it is cheap, 93.3% were satisfied with the treatment they received while 95.3% reported said they never had a problem after an extraction.

Conclusions

Tooth extractions using medicinal plants is well established in Lekie division, Cameroon. Infection control during extraction is not the norm. Traditional healers are willing to co-operate with oral health workers in improving the oral health of their patients. Mutual cooperation, collaboration and integrating TH into primary oral health care services need to be increased.