East African medical attitudes.

An overview of traditional views and practices is taken primarily from studies o, fifteen tribal societies. An emphasis on supernatural causes of disease, a dependence upon witchdoctors who utilize herbal and ritual remedies, and the use of surgical techniques were features common to most groups. Numerous health problems are shown to result from traditional beliefs. Among them ate dietary deficiencies, high infant mortality, and poor mental health. Proposals to incorporate the witchdoctor into modem practice are discussed, but considered unwise, although an analysis of herbal remedies is recommended, as is an emulation of the traditional emphasis upon social and emotional factors in illness. The need for widespread , innovative health education and for scientific measurement of its progress is stressed. TRADITIONAL MEDICAL SYSTEMS IF Tim modern medical practitioner is to understand popular reaction to his efforts, he must have some grasp of the traditions surrounding medical phenomena in his locale. Although attitude measurement is a field currently dominated by psychologists and sociologists, East African research of this type has generally employed anthropological methods, if not always professional anthropologists. In 1924, a clergyman, W. E. Owen, reported on disease concepts amongst the Kavirondo people of northern Kenya [I ]. Their animistic views, he said, led them to blame most diseases on the spirits of dead ancestors, whom they worshipped as a prophy-lactic measure. Several other forces, all supernatural, were named as disease agents. Owen described several attempts, some "successful", at sorcery in the area, and detailed cleansing rituals designed to prevent illness. This subjective, anthropological effort generally typified the methodology that would be employed in subsequent studies of other East African cultures and their medical views. Those studies, taken as a body, describe the medical systems within about 15 tribes, and will be given primary emphasis in the description of traditional systems which follows. Aetiological concepts The table below codifies views of disease causation, as reported in studies of 12 East African cultures.* If these studies can be considered complete, it becomes clear that there are obvious similarities from tribe to tribe, but that no one disease agent is recognized by all. This illustrates the danger inherent in any unqualified generalization about what "East Africans believe" [e.g. 2]. The table does not express the diversity of specific beliefs from tribe to tribe, but perhaps the following examples will serve to illustrate. (1) The Swahili of oceanside Kenya believed that convulsions in …