Seeking help for psychological distress: The interface of Zulu traditional healing and Western biomedicine

Notes

• An example of a diagnosis of a stepping over illness was observed at the home of a faith healer. A man of 22 consulted the faith healer complaining of feeling tired all the time, having headaches and being unable to find a job. He had already been to the hospital and stated that they had told him there was nothing wrong with him. The faith healer prayed and then informed the patient that one of his previous girlfriends had practised sorcery on him by giving him a stepping over illness. As a result a ‘ball of evil’ had entered his body through his foot and travelled up to his abdomen. She explained that the ball was currently rising up to his head and creating his current symptoms as well as preventing his success. The faith healer offered to prepare some medicines to remove the ball and the man agreed to return the following day to collect the medicines.
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• Observation of a consultation between a 48-year-old woman and a faith healer illustrates a diagnosis of an eating illness. The patient complained of feeling tired, having pains in her chest and losing weight. The woman's mood was anxious and her manner self-effacing. She explained that she had recently been admitted to the hospital. (Later examination of her hospital notes showed that she had been treated for gastritis and had a negative TB test.) Soon after discharge the symptoms had reappeared along with tiredness, loss of energy and she also felt that her relationship with her husband was deteriorating. The faith healer prayed at length and then explained that the symptoms were caused by sorcery. Someone had given her an eating illness but she was unable to name the person responsible. The illness had stopped in her chest and caused chest pains as well as producing a special dust that made her skin wrinkled. The faith healer advised that she should move in to the faith healers home for treatment. The patient decided to consult a diviner before making a decision. The patient returned to the faith healer after receiving confirmation that the illness was caused by sorcery. After five days of treatment, involving prayers, anointing with holy water and taking oral herbal medicines, the symptoms improved and the patient went home satisfied with the treatment and looking more relaxed and self confident.
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• The mother of a 17-year-old boy, who was admitted to hospital with a psychotic illness, explained how the family had consulted a faith healer about her son's symptoms of increasing withdrawal, incoherent speech and strange posture. The woman described how the faith healer had gone into a trance and taken the illness of the boy into her own body. The faith healer told the family that the illness was caused by a witch who had sent a familiar to harm the boy. However the faith healer had tired before she could gather further information and another meeting with the faith healer was therefore arranged. The son's behaviour had then become increasingly aggressive and unmanageable. The family had therefore brought him to hospital but planned to return to the faith healer when he was discharged.
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• A Zulu man explained that in the past the chief would have had such a person put to death by pushing a pole into his rectum.
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• This was illustrated during the observation of a home visit by the hospital nurse to the family of a 17 year old male patient with a psychotic illness probably schizophrenia. Family members repeatedly looked and gestured towards the rafters whilst discussing the role of their ancestors in managing the situation.
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• This concept of transferring the spirit was illustrated in an unexpected setting. The hospital arranged a meeting with local traditional healers. A group of healers were taken to see an operation that involved giving the patient an anaesthetic. A mask and ventilation bag was placed over the patient's airways before and after the surgery. A traditional healer commented that the spirit of the patient was being kept safely in the bag whilst the operation was in progress.
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• A female diviner explained that as a child she had been rather sickly with frequent headaches, stomach aches and pains all over her body. She often felt confused and had difficulty concentrating. She then began to have dreams about snakes. She was told that she had the ‘disease of the old’ meaning that the disease was due to the ancestors. Finally she had a dream about a local diviner and realized that she should train under him to become a diviner herself. However the diviner refused to take her on. Each year, for four years, she requested to be trained and each year he refused. The following year the woman had a dream that she would be run over by a tractor if she did not train. She therefore went to the diviner's house in the middle of the night and danced outside until the sun came up. The diviner finally agreed to train her. Her symptoms abated once she began the training.
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• A 24-year-old female teacher presented to the hospital accompanied by the daughter of a local faith healer who specialized in treating mental illnesses. She had been living at the home of the faith healer for the past week after being taken to the faith healer by her family bound in ropes because she had been agitated, running away and aggressive. During the hospital consultation the woman was disinhibited, and elated and insisted that she was the most beautiful woman in the world. The hospital doctor prescribed antipsychotic medication for treatment of a manic episode. The patient returned to the faith healers home. A visit to the faith healer one week later revealed the patient to be much more settled. The faith healer explained that the woman's illness was caused by sorcery. A neighbour, jealous of the teacher's status, had placed an eating illness in her food. The faith healer had treated her patient with holy water, prayer and herbal medicine. She had also been administering the antipsychotic medication. A further visit two weeks later showed further improvements in the patient. She had gradually begun to take responsibility for tasks in the homestead such as helping with cooking and attending visitors. Her mental state was settled and her mood appropriate and calm. It was planned that she would return to her own family for a short visit before returning home permanently.
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• The hospital psychiatric nurse explained that the hospital nurses often consulted traditional healers for their own health but did not admit to this. The nurse showed T.C. an area behind the nurse's quarters in the hospital where, discarded in the bushes, there were many empty boxes. These boxes were characteristically given to patients by traditional healers to hold their medicines. The nurses with whom I discussed the traditional healers were generally dismissive of their value and denied ever consulting them.
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• This treatment intervention can be seen as analogous to systems theory. The patient is considered within the context of the family system and a change instigated by the healer in one part of the system, the relationship between the boyfriend and the city girlfriend, leads to a change in another part of the system, Nonhale's symptomatology. It also illustrates the healers’ strategy of viewing the problem as evidence of a difficulty in the larger system rather than isolated in the individual patient.
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• Berglund (1976) refers to the ancestors as the ‘living dead’. This phrase usefully implies the present nature of the ancestors but has the unfortunate and inappropriate association with low budget horror films.
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