African Medical Pluralism

By William C. Olsen; Carolyn Sargent | Go to book overview

5
Medical Pluralism Revisited
A Memoir

Brooke Grundfest Schoepf

THIS VOLUME on medical pluralism raises an important question in an era when biomedicine is present in some form across most of sub-Saharan Africa, and formal schooling, including biology and human anatomy, is also widespread. Some may wonder why so many Africans continue to consult traditional healers.1 My first response is that most African children do not complete elementary school and are not taught biological science, and that most people do not have access to biomedicine of a reasonable standard. Sufferers’ social locations, and those of the people who assist them, greatly influence their trajectories as they review their options (Janzen 1978; Schoepf 1986; Colvin, Smith, Schwartz et al. 2013). Two factors encourage medical pluralism. First, consider the precarious state of education and health services available to the poor rural and urban majorities in most African countries. Although traditional healers’ therapies are seldom cheap and prices have risen in recent decades, many offer credit and delayed payment schemes, which biomedical services do not. Second, consider the cosmology involved in the diagnosis and explanation of the causes of sickness. These will be discussed in turn. First, a digression that may suggest a parallel.

My first experience with folk practitioners came in 1957, during village fieldwork in southern France, where Professor Mircea Eliade urged me to study the survival of traditional medicine in a rural community. When I consulted the elders, they laughed and pointed to the sole folk practitioner, a rebouteuse or bonesetter, an unkempt woman who lived up in the terraced hills at some remove from the village. They said that formerly she had set broken bones, attended births and treated many in the community for minor ills. At that time, the doctor was far away and transport uncertain. But now there was National Health Insurance, a pharmacist with a telephone down the hill, a sage-femme (midwife) in the next village, and the doctor who came regularly in her car from Toulon. I spent many hours perched on a stool in the back room of the pharmacy as people came to discuss their complaints with Monsieur le Pharmacien to decide whether to consult a doctor or to try an over-the-counter remedy first.

-110-

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