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The Role of Traditional Healers in Community-Based HIV Care in Rural Lesotho

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Abstract

Traditional healers provide a substantial proportion of health care in resource-poor settings, including countries with high burdens of HIV in sub-Saharan Africa. Traditional healers have played many roles in HIV care, but some biomedical providers view them as obstacles in providing HIV treatment. This is a qualitative study exploring the roles played by traditional healers in a community-based program rolling out antiretroviral therapy (ART) in two rural communities in Lesotho. Seventeen traditional healers took part in interviews focus groups, and participant observation sessions over a 2 years period. Data showed they provided a wide range of HIV services prior to the ART rollout. Baseline knowledge regarding HIV was high, but healers reported mixed emotions about the planned ART rollout. Joint meetings were held between biomedical providers and traditional healers, and a collaborative model of care resulted. Traditional healers took on a variety of roles in the ART rollout, including HIV prevention activities, HIV testing, monitoring patients, and participating in joint learning sessions. All of the traditional healers underwent HIV testing and 7/17 (41.2%) tested positive for the disease, of whom four were eligible for and enrolled in ART. Healers expressed an appreciation for the collaboration with biomedical providers and being paid for their referrals. However, some expressed concern about the biomedical providers’ lack of understanding of HIV in the local context. This research shows that traditional healers can provide a variety of community-based HIV services and are not obstacles for advancing care in the communities they serve.

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References

  1. Mark, G. T., & Lyons, A. C. (2010). Maori healers’ views on wellbeing: the importance of mind, body, spirit, family and land. Social Science and Medicine, 70(11), 1756–1764.

    Article  PubMed  Google Scholar 

  2. Broom, A., Doron, A., & Tovey, P. (2009). The inequalities of medical pluralism: Hierarchies of health, the politics of tradition and the economies of care in Indian oncology. Social Science and Medicine, 69(5), 698–706.

    Article  PubMed  Google Scholar 

  3. Wiseman, V., Scott, A., Conteh, L., McElroy, B., & Stevens, W. (2008). Determinants of provider choice for malaria treatment: Experiences from The Gambia. Social Science and Medicine, 67(4), 487–496.

    Article  PubMed  Google Scholar 

  4. Berhane, Y., Gossaye, Y., Emmelin, M., & Hogberg, U. (2001). Women’s health in a rural setting in societal transition in Ethiopia. Social Science and Medicine, 53(11), 1525–1539.

    Article  PubMed  CAS  Google Scholar 

  5. Ellis, A. A., Winch, P., Daou, Z., Gilroy, K. E., & Swedberg, E. (2007). Home management of childhood diarrhoea in southern Mali–implications for the introduction of zinc treatment. Social Science and Medicine, 64(3), 701–712.

    Article  PubMed  Google Scholar 

  6. Chipfakacha, V. G. (1997). STD/HIV/AIDS knowledge, beliefs and practices of traditional healers in Botswana. AIDS Care, 9(4), 417–425.

    Article  PubMed  CAS  Google Scholar 

  7. Kiesser, M., McFadden, J., & Belliard, J. C. (2006). An interdisciplinary view of medical pluralism among Mexican-Americans. Journal of Interprofessional Care, 20(3), 223–234.

    Article  PubMed  Google Scholar 

  8. DS, U. N. A. I. (2010). Report on the global AIDS epidemic. Geneva, Switzerland: UNAIDS.

    Google Scholar 

  9. Sepkowitz, K. A. (2001). AIDS–the first 20 years. New England Journal of Medicine, 344(23), 1764–1772.

    Article  PubMed  CAS  Google Scholar 

  10. Mukherjee, J. S., Farmer, P. E., Niyizonkiza, D., McCorkle, L., Vanderwarker, C., Teixeira, P., et al. (2003). Tackling HIV in resource poor countries. British Medical Journal, 327(7423), 1104–1106.

    Article  PubMed  CAS  Google Scholar 

  11. Kalwinsky, R. K. (2008). Western worms! Explication of aspects of health care behavior among Chamorro with HIV/AIDS. Journal of Transcultural Nursing, 19(1), 55–63.

    Article  PubMed  Google Scholar 

  12. Okome-Nkoumou, M., Okome-Miame, F., Kendjo, E., Obiang, G., Kouna, P., Essola-Biba, O., et al. (2005). Delay between first HIV-related symptoms and diagnosis of HIV infection in patients attending the internal medicine department of the Foundation Jeanne Ebori (FJE), Libreville, Gabon. HIV Clinical Trials, 6(1), 38–42.

    Article  PubMed  Google Scholar 

  13. Peters, E. J., Immananagha, K. K., Essien, O. E., & Ekott, J. U. (2004). Traditional healers’ practices and the spread of HIV/AIDS in south eastern Nigeria. Tropical Doctor, 34(2), 79–82.

    PubMed  CAS  Google Scholar 

  14. Dahab, M., Charalambous, S., Karstaedt, A., Fielding, K., Hamilton, R., La Grange, L., et al. (2010). Contrasting predictors of poor antiretroviral therapy outcomes in two South African HIV programmes: A cohort study. BMC Public Health, 10, 430.

    Article  PubMed  Google Scholar 

  15. Knox, J. (2010). Exploring the potential for a culturally relevant HIV intervention project: A Swaziland example. Anthropology and Medicine, 17(1), 87–98.

    Article  PubMed  Google Scholar 

  16. Ivers, L. C., Smith Fawzi, M. C., Freedberg, K. A., & Castro, A. (2007). Late presentation for HIV care in central Haiti: Factors limiting access to care. AIDS Care, 19(4), 487–491.

    Article  PubMed  Google Scholar 

  17. Gouws, E., Stanecki, K. A., Lyerla, R., & Ghys, P. D. (2008). The epidemiology of HIV infection among young people aged 15–24 years in Southern Africa. AIDS, 22(S4), S5–S16.

    Article  PubMed  Google Scholar 

  18. Rajaratnam, J. K., Marcus, J. R., Flaxman, A. D., Wang, H., Levin-Rector, A., Dwyer, L., et al. (2010). Neonatal, postneonatal, childhood and under-5 mortality for 187 countries, 1970–2010: A systematic analysis of progress towards millennium development goal 4. Lancet, 375(9730), 1988–2008.

    Article  PubMed  Google Scholar 

  19. UNDP. (2011). http://hdrstats.undp.org/en/countries/country_fact_sheets/cty_fs_LSO.html. January 22.

  20. WHO. (World Health Organization). (20111). http://www.who.int/countries/lso/en/. January 22.

  21. Kohi, T. W., Portillo, C. J., Durrheim, K., Dlamini, P. S., Makoae, L. N., Greeff, M., et al. (2010). Does perceived HIV stigma contribute to nurses’ intent to migrate in five African countries? Journal of the Association of Nurses in AIDS Care, 21(2), 134–143.

    Article  PubMed  Google Scholar 

  22. Furin, J., Shutts, M., & Keshavjee, S. (2008). Aviation and the delivery of medical care in remote regions: The Lesotho HIV experience. Aviation Space and Environmental Medicine, 79(2), 136–138.

    Article  Google Scholar 

  23. Mills, E., Singh, S., Wilson, K., Peters, E., Onia, R., & Kanfer, I. (2007). The challenges of involving traditional healers in HIV/AIDS care. International Journal of STDs and AIDS, 18(1), 68–69.

    Article  Google Scholar 

  24. Furin, J. J., Rigodon, J., Cancedda, C., Keshavjee, S., Seung, K. J., Letsie, M., et al. (2007). Improved case detection of active tuberculosis associated with an antiretroviral treatment program in Lesotho. International Journal of Tuberculosis and Lung Disease, 11(10), 1154–1156.

    PubMed  CAS  Google Scholar 

  25. Furin, J. J., Behforouz, H. L., Shin, S. S., Mukherjee, J. S., Bayona, J., Farmer, P. E., et al. (2008). Expanding global HIV treatment: Case studies from the field. Annals of the New York Academy of Sciences, 1136, 12–20.

    Article  PubMed  CAS  Google Scholar 

  26. Government of Lesotho. (2011). http://www.health.gov.ls/documents/KYS Messages January 22.

Download references

Acknowledgments

Funding for this work was provided by Irish Aid and the Francois-Xavier Bagnoud Center for Health and Human Rights, Harvard School of Public Health. Deepest gratitude is given to the people of Lesotho who shared their lives in this study. The author has no conflict of interest or financial disclosures to declare.

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Correspondence to Jennifer Furin.

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Furin, J. The Role of Traditional Healers in Community-Based HIV Care in Rural Lesotho. J Community Health 36, 849–856 (2011). https://doi.org/10.1007/s10900-011-9385-3

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