The World Health Organization has recognized 'traditional medicine' as a de facto and economical substitute for biomedicine in the developing world. Accordingly, the Zambian government aims to integrate 'traditional healers', locally known as ng'anga, with their biomedical counterparts in a national health care system. Hence, on the one hand, ng'anga elaborate their practice into 'herbalism', which could meet scientific standards and fit into the scope of biomedicine. On the other hand, they continue to deal with affliction by positing the existence of occult agents, such as witchcraft and spirits, at the risk of being criticized for exploiting indigenous beliefs. As a result, many ng'anga associate themselves with Christianity, the national religion of Zambia, which serves as an official domain of the occult where they take refuge from biomedical rationalization. However, conventional churches, the government and health authorities do not approve of the link between Christianity and traditional medicine; hence ng'anga as traditional healers are marginalized in modern, Christian Zambia. Being thus dissociated from the national religion, ng'anga are officially confined to the periphery of national health care, where they submit to the primacy of biomedicine and the workings of state power.
L'Organisation mondiale de la Sante reconnait desormais la << medecine traditionnelle >> comine un substitut de facto et economique a la biomedecine dans les pays en developpement. Dans cet esprit, le gouvernement zambien vise a integrer les << guerisseurs traditionnels >>, connus localement sous le nom de ng'anga, dans un systeme de sante national aux cetes de leurs homologues biomedicaux. En consequence, les ng'anga travaillent d'une part a l'elaboration de leur pratique d' << herboristerie >>, qui pourrait repondre aux normes scientifiques et entrer dans le champ d'application de la biomedecine. D'autre part, ils continuent de traiter des afflictions en posant en principe l'existence d'agents occultes tels que sorcellerie et esprits, au risque d'etre critiques pour leur exploitation de croyances indigenes. C'est pourquoi de nombreux ng'anga s'associent au christianisme, religion nationale de la Zambie, qui sert de domaine officiel de l'occulte dans lequel ils prennent refuge de la rationalisation biomedicale. Neanmoins, les eglises conventionnelles, le gonvernement et les autorites sanitaires desapprouvent le lien entre christianisme et medecine traditionnelle; c'est pourquoi les ng'anga, en tant que guerisseurs traditionnels, sont marginalises dans la Zambie chretienne contemporaine. Ainsi dissocies de la religion nationale, les ng'anga sont officiellement confines a la peripherie du systeme de sante national, d'ou ils se soumettent a la suprematie de la biomedecine et aux mecanismes du pouvoir etatique.
'Traditional medicine' refers to 'ways of protecting and restoring health that existed before the arrival of modern medicine', according to the World Health Organization (1996), which started to promote such methods in the 1970s. The promotion has centred largely on 'developing' non-Western countries that have financial difficulty implementing 'modem medicine', namely biomedicine. Positing that most people in those countries are reliant on traditional medicine, WHO suggests that 'traditional healers' be integrated into national systems, and utilized as 'inexpensive providers of primary health care' (Maclean 1987: 7). Being thus considered to be a de facto substitute for biomedicine in the developing world, traditional medicine has attracted government intervention, international support and academic investigation. In Africa in particular, a trend towards the integration of traditional healers grew quickly in many countries, although their position in national health care has since remained uncertain (Last 1986). This article explores the situation in Zambia by drawing on my fieldwork in Lusaka at the end of the 1990s, in which I looked at the state-level shaping of traditional medicine in parallel with the activity of traditional healers, locally known as ng'anga, in a mostly impoverished township called Kalingalinga. …