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Thesis (Ph.D.)(Political Science) --University of Limpopo, 2009. / The primary aim of this study was to advocate for a collaborated health care delivery system that includes indigenous African medicine and is administered and controlled by the government. The objectives were:  To demonstrate how apartheid disrupted the natural development of indigenous healing practices. To dispel the misconception about the use of indigenous African medicine in the treatment of diseases. To demonstrate the need to protect both indigenous African and western European medicine. To demonstrate that African patients consult both indigenous African and western European doctors for various aspects of their treatment in their health care choices. To demonstrate that patients expect the government to provide an effective health delivery system. The main research question was: How can South Africa develop a collaborated health care delivery system using both indigenous African and biomedical health professionals that is effective and open to everyone on an equal basis? The theoretical framework for this study was the Afro-centric worldview in which events and ideas are perceived from an African perspective with the African people as the main players rather than victims. At the centre of the study were the African people, their health, disease pattern and healing practices. The Afro-centric qualitative research design was used. A sample size of 15 indigenous African doctors, 50 western European oriented health professionals and 84 patients participated in the study. The open coding method of data analysis was used to analyze data obtained from semi-structured in-depth interviews. The major findings of the study are that:  The belief of the African people in the existence of the ancestors and spirituality remains unshakeable. The strong belief n the ancestors make the diagnosis and treatment of diseases essentially religious practices. In the African culture, there are no preventative measures against natural illnesses, but there are preventative measures that are used against witchcraft/sorcery from entering a homestead and causing illness among members of a family. African people utilize both health care systems simultaneously and/or interchangeably depending on the seriousness of the illness and the knowledge and experiences that the illness can be effectively treated using indigenous African medicine or biomedicine. Both indigenous African doctors and biomedical health professionals play an important role in the provision of health. Recommendations The study recommends that when policy guidelines on the collaboration of indigenous African and western European medicine are drawn up, the following should be considered: Legislation to protect indigenous knowledge on African medicine Legislation that controls the qualification and registration of indigenous African doctors. Inclusion of indigenous African medicine in the curricula of all health professionals. / N/A

Submitted by BÁRBARA PACHECO CARITA SIMOES LOPES null (ba.lopes08@gmail.com) on 2017-06-27T19:42:49Z No. of bitstreams: 1 Barbara_Lopes_dissertacao completa_27jun.pdf: 4435164 bytes, checksum: 61bb45f0c38920856efe44492223bdf5 (MD5) / Approved for entry into archive by Luiz Galeffi (luizgaleffi@gmail.com) on 2017-06-28T20:06:55Z (GMT) No. of bitstreams: 1 lopes_bpcs_me_bot.pdf: 4435164 bytes, checksum: 61bb45f0c38920856efe44492223bdf5 (MD5) / Made available in DSpace on 2017-06-28T20:06:55Z (GMT). No. of bitstreams: 1 lopes_bpcs_me_bot.pdf: 4435164 bytes, checksum: 61bb45f0c38920856efe44492223bdf5 (MD5) Previous issue date: 2017-05-04 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As plantas medicinais constituem um domínio essencial na medicina e saúde indígena. As questões de saúde e doença na medicina indígena implicam conexões entre natureza, cultura, questões físicas e espirituais. Para os Kaxinawá, as doenças não possuem causas únicas, sendo produzidas por um conjunto de forças internas e externas, enquanto os desenvolvimentos físico, mental, emocional e espiritual estão relacionados entre si. Este trabalho busca compreender os elementos presentes na medicina Kaxinawá, apresentando características relacionadas à manipulação das plantas de uso medicinal em processos de saúde e doença. Assim, o objetivo geral desta pesquisa é realizar um levantamento etnobotânico das plantas medicinais utilizadas pelos Kaxinawá e, por meio de seu registro, contribuir para o fortalecimento da resiliência do sistema tradicional de saúde indígena envolvido. Esta pesquisa realiza-se com a participação das cinco comunidades da Terra Indígena Kaxinawá de Nova Olinda (TIKNO), no Alto Rio Envira, município de Feijó - AC, Brasil. A coleta dos dados foi realizada em quatro viagens de campo, por meio da observação participante e de 41 entrevistas semi-estruturadas para o levantamento das informações socioculturais dos/as participantes, e das plantas medicinais com a técnica da lista livre. A análise de dados foi quali-quantitativa. Foram utilizados parâmetros da etnobotânica quantitativa e a criação de categorias analíticas de agrupamento em função dos usos das plantas medicinais listadas. A alimentação está intimamente relacionada à saúde e foi percebida uma forte relação entre os usos das plantas e as figuras de animais que perfazem a caça consumida. As características dos alimentos e contextos individuais ou sociais podem determinar sintomas ou doenças e relacionam-se ao diagnóstico e à escolha do remédio utilizado. A partir de um primeiro olhar sobre os usos etnobotânicos das plantas medicinais na TIKNO, sua riqueza e abrangência, é possível perceber o reflexo da apropriação sociocultural da biodiversidade local e da cosmovisão Kaxinawá no entendimento de saúde e doença. As práticas para manutenção da saúde enfatizam a importância das plantas medicinais e do conhecimento tradicional dos Kaxinawá, o que também evidencia a relevância de seu registro. / Medicinal plants are a fundamental domain in Indigenous Medicine and health. Health and sickness matters in the Indigenous Medicine imply in connections among Nature, Culture, physical and spiritual subjects. For the Kaxinawá, diseases are not related to a single root, but are originated in a series of internal and external forces, as the physical, mental, emotional and spiritual developments are linked. The present study envoys to comprehend the elements present in the Kaxinawá Medicine, presenting characteristics related to the medicinal plants in health and sickness processes. Therefore, the objective of this study is to attain a ethnobotanical data collection regarding medicinal plants employed by the Kaxinawá and, through such record, to contribute to the strengthening of the related traditional indigenous health system resilience. This research was accomplished through the involvement of four communities from the Terra Indígena Kaxinauá de Nova Olinda (TIKNO), in the Alto Rio Envira, in the city of Feijó – AC, Brazil. Data collection was done through participating observation and 41 semi-structured interviews for the listing of sociocultural information of the participants, and for the medicinal plants the free listing technic was employed. Data analysis was quali-quantitative. Quantitative Ethnobotany parameters and the analytical categorization of grouping regarding employ functions of the listed medicinal plants were applied. Medicinal plants, for the Kaxinauá, are the equivalent for “Medicine”. Eating is intimately related to health and a strong relation between plant usage and animal models that represent the consumed game animal was noticed. Food characteristics and individual or social contexts can determine symptoms or diseases and are related to the diagnosis and medicine choice. From a first glance on the ethnobotanic usage of medicinal plants in the TIKNO, their richness and coverage, the repercussion of the local biodiversity sociocultural appropriation and the Kaxinauá worldview on health and disease can be perceived. The practices for health maintenance stress the medicinal plants and the Kaxinawá traditional knowledge importance, as well as the relevance of such record.

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Herbal medicines remain integral part of indigenous health care system in Ghana. Most conventional health medicines are directly or indirectly derived from plants or herbs. Despite its significant role in modern medicine indigenous herbal practices has been on the low light for some time due to perceived antagonistic relationship that exists between practitioners of herbal medicine and their counterpart in the conventional system. Using an indigenous knowledge discursive framework, the thesis examined the relevance of herbal medicine to the contemporary Ghanaian society. The thesis also examined the tension between the indigenous herbal practitioners and their orthodox counterparts. The thesis noted that for health care system in Ghana to be effective, there is a need for collaborate relations between these two practitioners. Also, it was noted that for health care system to be effective in Ghana, spirituality has to be central in the works of the herbal practitioners.

Herbal medicines remain integral part of indigenous health care system in Ghana. Most conventional health medicines are directly or indirectly derived from plants or herbs. Despite its significant role in modern medicine indigenous herbal practices has been on the low light for some time due to perceived antagonistic relationship that exists between practitioners of herbal medicine and their counterpart in the conventional system. Using an indigenous knowledge discursive framework, the thesis examined the relevance of herbal medicine to the contemporary Ghanaian society. The thesis also examined the tension between the indigenous herbal practitioners and their orthodox counterparts. The thesis noted that for health care system in Ghana to be effective, there is a need for collaborate relations between these two practitioners. Also, it was noted that for health care system to be effective in Ghana, spirituality has to be central in the works of the herbal practitioners.

According to the United Nations High Commissioner for Refugees (UNHCR), by 2012 there were 15.4 million refugees and 28.8 million internally displaced persons (IDPs) forced to flee their homes due to war or violent conflict across the globe. Upon arrival in their host settings, forced migrants struggle with acute health and material needs, as well as issues related to identity, politics, power and place. The Karen ethnic minority of Burma (also known as Myanmar) has been involved in a prolonged civil conflict with the Burmese military government for nearly six decades. This fighting has resulted in massive internal displacement and refugee flight, and although a ceasefire was signed in 2012, continued violence has been reported. This study among the displaced Karen population along the Thai-Burma border examines the relationships between traditional – or indigenous – medicine, the population's health needs, and the broader social and political context. Research was conducted using an ethnographic case-study approach among 170 participants along the Thai-Burma border between 2003 and 2011. Research findings document the rapid evolution and formalisation of the Karen traditional medical system. Findings show how the evolutionary process was influenced by social needs, an existing base medical knowledge among traditional health practitioners, and a dynamic social and political environment. Evidence suggests that that Karen traditional medicine practitioners, under the leadership of the Karen National Union (KNU) Department of Health and Welfare, are serving neglected and culturally-specific health needs among border populations. Moreover, this research also provides evidence that Karen authorities are revitalising their traditional medicine, as part of a larger effort to strengthen their social infrastructure including the Karen self-determination movement. In particular, these Karen authorities are focused on building a sustainable health infrastructure that can serve Karen State in the long term. From the perspectives of both refugee health and development studies, the revival of Karen traditional medicine within a refugee and IDP setting represents an adaptive response by otherwise medically under-served populations. This case offers a model of healthcare self-sufficiency that breaks with the dependency relationships characteristic of most conventional refugee and IDP health services. And, through the mobilisation of tradition for contemporary needs, it offers a dimension of cultural continuity in a context where discontinuity and loss of culture are hallmarks of the forced migration experience.

Les populations autochtones au Canada, comme partout dans le monde, sont moins en santé que leur contrepartie non autochtone. La médecine traditionnelle, notamment pour les populations autochtones, offre une avenue intéressante à une amélioration de leur santé et elle peut être mise en place dans les programmes de santé publique. Par la notion de culture inscrite dans la MT, celle-ci permet d’offrir des soins culturellement adaptés. Bien que de nombreux avantages découlent de la combinaison des médecines, la combinaison dans un contexte de soins primaires présente des défis. À ce jour, il semble que les organisations de santé aient des difficultés à bien arrimer ces deux approches de soins. L’objectif général de cette étude consiste à comprendre et analyser la dynamique d’interactions ayant cours entre les acteurs qui participent à la conception, au développement et à la planification d’une offre de soins et services qui permette une combinaison des MT et la MA. Cette recherche qualitative avec cas multiples est menée dans deux communautés autochtones du Québec, de nations ilnue et crie, ayant des caractéristiques variées. Les données proviennent d’entrevues individuelles et d’ateliers de transfert de connaissances réalisés auprès des aînés et guérisseurs, des patients, des professionnels et des administrateurs de la santé, ainsi que de documents écrits et d’observations sur le terrain. Le cadre conceptuel s’appuie sur l’analyse stratégique de Crozier et Friedberg (1977) et sur le système des professions d’Abbott (1988). Cette recherche met en évidence les multiples dimensions ayant un impact sur une offre de soins combinés. Ces dernières peuvent entre autres être liées à la culture comme les modes de transmission du savoir, et aux contextes organisationnel, administratif, réglementaire et même géographique. De plus, la compréhension des enjeux et des stratégies des parties prenantes permet de mieux comprendre l’organisation de chacun des deux mondes. Nos résultats montrent que, dans les deux cas à l’étude, la combinaison des deux médecines est coordonnée par le patient (modèle du patient coordonnateur). Mais dans un des cas, le patient est davantage soutenu dans sa trajectoire de soins. Une meilleure compréhension des dynamiques d’interaction entre les parties prenantes permet d’avoir un impact sur une offre des soins mixtes améliorant la santé des autochtones. Cette étude soutient le développement d’un modèle de soins qui met de l’avant les médecines traditionnelles et suscite une réflexion sur les facteurs qui influencent la mise en œuvre d’une combinaison des médecines. / Indigenous peoples in Canada and around the world are less healthy than their non-Indigenous counterparts. Traditional medicine, especially for Indigenous populations, offers an interesting avenue for improving their health and it can be implemented in public health programs. Through the notion of culture enshrined in traditional medicine, the latter can provide culturally appropriate care. Although many advantages are derived from such mixed care models, this combination has significant challenges. To date, it seems that health organizations have difficulty to properly engage these two-health approaches. The consideration of Indigenous knowledge and healing practices has begun, but it remains fragmented with discontinuous health services offered to the population. The general objective of this research is to understand and analyze the dynamics of interaction going among actors who involved in the implementation of a mixed care model of delivery of services that combines traditional and allopathic medicines. This multiple case qualitative research is conducted at two Indigenous communities in Quebec, Ilnu and Cree nations, with various characteristics. The data comes from individual interviews and knowledge transfer workshops with elders and healers, patients, health professionals and health administrators, as well as written documents and participant observations. The conceptual framework builds on the strategic analysis of Crozier and Friedberg (1977) and Abbott’s system of professions (1988). This research highlights the multiple dimensions that have an impact on a mixed care offer. These can, among other things, be related to culture such as the modes of transmission of knowledge, and to organizational, administrative, regulatory and even geographic contexts. In addition, understanding the challenges and strategies of the actors makes it possible to better understand both worlds. Our results show that, in the two cases under study, the combination of the two medicines is coordinated by the patient (patient coordinator model). But in one of the cases, the patient is more supported in his care trajectory. A better understanding of the dynamics of interaction between stakeholders makes it possible to have an impact on the delivery of mixed care improving the health of Indigenous people. This study has the potential to impact on the delivery of combined health care services, thereby improving prevention and health promotion for both Indigenous and non-Indigenous peoples. It supports the development of an alternative model of care, putting forward Indigenous traditional medicine. It encourages the reflection on the different factors involved in combining medicines.

The purpose of this study was to explore and describe experiences of HIV/AIDS positive patients using Sesotho traditional medicines at Scott Hospital in Morija, Lesotho. The specific objectives were to explore and describe the experiences and views of patients using Sesotho traditional medicines. The study uded an explorative qualitative design with a sample of seventeen (17) HIV positive adults aged 18-49 years who were purposively sampled. The major findings of the study were that; Sesotho traditional medicines improved the health status of the participants; and also they were of the view that Sesotho traditional medicines work as they beneficially contributed to HIV/AIDS management. The study concludes that Sesotho traditional medicines are believed and understood to play a role in the symptomatic management of HIV/AIDS even though the actual role they play is yet to be proven scientifically. / Department of Health Studies / M.A. (Public Health)