Collaboration or renunciation? The role of traditional medicine in mental health care in Rwanda and Eastern Cape Province, South Africa

ABSTRACT

Traditional medicine (TM) and biomedicine represent parallel health systems in many developing countries; the latter dominating in public policies, while the former still retain considerable influence among the general public. This study investigates how mental health care professionals responsible for mental health care implementation comprehend and relate to the intersection between TM and biomedicine in the cases of Rwanda and the Eastern Cape Province, South Africa. The material is based on semi-structured interviews with mental health care stakeholders in Eastern Cape, South Africa and Rwanda. The findings confirm an impact of TM in the treatment of mental health issues in Rwanda and South Africa due to TM being more accessible than biomedical medicine, widespread traditional perceptions of mental illness in society, and the lack of knowledge of biomedical treatments. Furthermore, the respondents identified three strategies to manage the impact of TM; improved accessibility of biomedical facilities, outreach education about mental illness, and, in the Eastern Cape case, collaboration between traditional healers and biomedicine. The study points to the necessity to take TM into consideration as an important component of health systems and policies in the Global south.

KEYWORDS:

• Rwanda
• South Africa
• traditional medicine
• right to mental health
• global health systems

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Rwanda and South Africa have revised and developed national laws and policies concerning mental health care in the last decade (RoR, 2012; RSA, 2002). Following WHO guidelines, the mental health care systems in both countries provide mental health care services in a decentralised model, integrating them into the primary health care system.

2 The framework consists of four interrelated and overlapping elements. Availability focuses primarily on the physical aspects of health services (such as hospitals, clinics, trained medical staff, medicines, clean water, and sanitation facilities) and if these are available in sufficient quantity. Accessibility requires that health services are accessible to everyone and has four overlapping dimensions; non-discrimination, physical accessibility, economic accessibility (affordability), and information accessibility (the right to seek, receive, and impart information on health). Acceptability requires that health facilities, goods, and services must be respectful of medical ethics and the culture of individuals, minorities, peoples, and communities. Quality requires that health care services must be scientifically and medically appropriate; that health professionals are trained and skilled; and that drugs, medicines, and hospital equipment are scientifically approved (UN, 2000).

Additional information

Funding

This research was funded by the Swedish International Development Cooperation Agency (SWE-2010-058, SWE-2010-226).