Theme 7

• Cultural perspectives on health


  Examine cultural practices and their impact on health
• Human beings are social beings with an innate desire to conform to socially accepted norms and values
• Over periods of time, some of these norms become standards that all members of a society are expected to adhere to
• Deviance from these standards may be seen as immoral
• For centuries, Africans have trusted and relied on indigenous traditional medicine to treat physical and mental illnesses
• Western missionaries and colonisation criticised traditional medicine and healing as witchcraft
• Colonisers


  1. Passed laws that prohibited the use of indigenous medicine

  2. Made traditional medicine unlawful

  3. Encouraged Africans to practice Christianity
• Most Africans still believe in ancestorial powers and are not restricted to consult traditional healers for treatment
• Researchers report that traditional medicine is still accessible and used by 80% of the African population
• Traditional medicine (TM)


  The knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses
• What all cultures have systems of health and medical beliefs based on

  • What causes illness
  • How it can be cured or treated
  • Who should be involved in the treatment process
• Distinction between illnesses to consult a medical doctor or traditional healer

  Possess the knowledge to distinguish which kind of illness to consult a medical doctor or traditional healer for treatment or traditional medicine
• Importance of traditional medicine to Africans

  • It values individual's life, their family, society they come from, spirituality, and the environment they live in
  • It is accessible to a large population because it is affordable
  • It ensures more equitable access to health care especially the less privileged
• Reasons individuals rely on traditional health practitioners

  • Poor healthcare facilities
  • Lack of specialist care
  • Limited financial resources
• Individuals may seek out traditional treatments after being diagnosed with an incurable (though controllable disease) that may be deemed unacceptable, or in cases where a medical personnel cannot find an organic cause to explain a patient's symptoms
• 39 countries in Africa have national traditional medicine offices and 24 of the countries have TM programs incorporated in their Health Ministries
• Prior to Namibia's independence traditional medicine was banned
• Post independence, the Namibian government

  1. Recognised the diversity of the use of traditional medicine practices and its contribution to health and wellbeing

  2. Started discussions on the introduction of the Traditional Health Practitioners (THP) Bill
• Aims of the THP Bill

  • Regulating the registration of THPs and the practising of traditional healing
  • Integrating the essential parts of traditional healing into mainstream healing practices
  • Allowing the formation of the THPs Council of Namibia
  • Protecting and serving the interests of the members of the public who intend to utilise TM or those who are affected by, the services provided by registered THPs
• The THP bill (tabled in 2014) is yet to be finalised and approved
• The number of active THPs was estimated at 2,400, making it a wide-spread practice in Namibia
• A pilot study found that THPs play a major role in primary health care and social welfare of the disadvantaged population in Namibia
• THPs' approach to treatment

  • Acknowledge the role of Western medicine in the treatment of illnesses with a biological basis
  • Health issues with spiritual cause (i.e., epileptic seizures and mental illness), where mainstream medicine has failed to provide a permanent cure are deemed best treated by traditional medicine
  • Diagnostics and treatment practices of TM are guided by divination and the use of plant and animal-based materials
  • Treatment success is measured by the complete absence of symptoms
• Many of the cultural beliefs and practices have no scientific basis and some of the cultural practices promote behaviours with negative health consequences
• Some cultural practices may appear to not have immediate health impacts, but some may have direct and indirect long-term health consequences on individuals, families and society at large
• Wife exchanging culture in Northern Namibia

  • Expression of appreciation of male friend or visitor by giving the friend or visitor their wife to sleep with for the night
  • Believed to be an act of kindness, warm welcome, deepens their friendship and prevents promiscuity
• Health implications of wife exchanging culture

  • Spread of STIs including HIV/AIDS
  • It will be interesting to establish if the wives given as sexual gifts to friends and visitors have a say in such a decision and, if they appreciate such a cultural practice
• Female Genital Mutilation (FGM)


  Part of, or the entire external female genital is cut off as a cultural practice believed to reduce libido and enhance the chastity of women
• Health implications of FGM

  • Unsterilised devices
  • Severe bleeding
  • Injuries to the urinary tract
  • Risk of complicated childbirth and death of the newborn
  • Causes painful sexual intercourse
  • Associated with depression, anxiety, post-traumatic stress disorder and low self-esteem
  • It has absolutely no health benefit for girls/women
• The Wodaabe's wife stealing night dance


  A cultural practice where during a dancing festival at night, a man is allowed to steal and carry home any woman he likes (whether the woman is married or not)
• Health implications of the Wodaabe's wife stealing night dance

  • STIs including HIV/AIDS
  • Unwanted pregnancies
• The Chawe cultural corpse washing ritual


  When a member of the Chawe tribe dies, the throat of the corpse is sliced open, and water is run through then squeezed out until it comes out looking clear. Water from the corpse is collected and used to prepare a meal for the entire community.
• Health implications of the Chawe cultural corpse washing ritual

  • Spread of infectious diseases
  • Gastrointestinal diseases
  • Food poisoning
  • Hepatitis
  • Typhoid fever or cholera
• The Banyankole tribe's potency test in Uganda


  The older female matron is required to test the sexual potency of the intending husband by having sexual intercourse with him, and test the "purity" of the intending wife by examining her hymen before they are allowed to marry
• Health implications of the Banyankole tribe's potency test

  • Promote STIs
  • Female genital tract infections
  • Lower the self-esteem of the vulnerable young couple who may be ridiculed if declared to fall short of the required standards
• Sharo beating ritual of Benin Uganda

  An intending husband may be required to endure severe beating to prove his worthiness of the wife. If the husband is unable to endure the flogging, the marriage is called off.
• Health implications of the Sharo beating ritual

  • Death (Many intending husbands have died from the flogging ritual)
  • Physical and psychological trauma to the intending husband
• Fortunately, the Sharo beating ritual is no longer a compulsory requirement for marriage
• Addressing cultural practices with adverse health consequences


  • International involvement to stop FGM (WHO, UNICEF and UNFPA) that declared FGM a public health concern
  • International monitoring bodies and resolutions that condemn harmful practices
  • Revised legal frameworks and growing political support to end FGM (this includes a law against FGM in 26 countries in Africa and the Middle East, as well as in 33 other countries with migrant populations from FGM practicing countries)
• Health education of communities to be aware of health consequences of aspects of cultural practices that have adverse health consequences