Eleanor Ross

Traditional healing in South Africa: ethical implications for social work.

ABSTRACT Within health-care settings, culturally competent practice presupposes an understanding of the socio-cultural meanings attached to illness and disability and the people who are likely to be consulted with respect to providing health care and restoring well-being. Large numbers of South Africans are known to consult with traditional healers in preference to or in conjunction with western, allopathic health-care professionals. The present study represents a secondary analysis of data from various studies conducted on Black African, Muslim, Hindu and Chinese traditional healing systems in South Africa. Common themes that emerged from the analysis included the attribution of illnesses and disorders to spiritual factors, punishment and superstitious beliefs. Treatment approaches included the use of natural substances, prayer and rituals, and procedures that were designed to restore equilibrium. Theparticipants also articulated their views on medical pluralism, collaboration between western and traditional health-care practitioners, and reasons why people consulted with traditional healers. The findings are discussed in terms of their ethical implications for social work.

Beliefs and practices of Black South African traditional healers regarding hearing impairment

The study investigated beliefs and practices of Black South African traditional healers regarding hearing impairment. Fifteen Black South African traditional healers were interviewed using a semi-structured interview schedule. An exploratory-descriptive research design incorporating a mixed qualitative/quantitative method was employed and data were collected via individual interviews. Traditional healers reported being consulted for what could possibly reflect a variety of audiological and otological problems, and using a wide range of diagnostic and treatment techniques. Although the healers mentioned infection, organic deterioration, noise exposure, and congenital aspects as cause of hearing impairment; they tended to anthropomorphise the cause of the disease, and the reason for becoming ill was often sought in a supernatural realm. These findings have implications for culturally sensitive practice, collaboration between traditional healers and audiologists, sharing of information regarding hearing impairment, mutual referrals, and involvement of traditional healers in hearing health care.

Approaches of South African Traditional healers regarding the treatment of cleft lip and palate

Objective Due to the large number of Black South Africans known to consult with traditional healers and the influential role they play in the developing world, this study investigated the approaches of a group of 15 traditional healers toward the treatment of cleft lip and palate. Design An exploratory-descriptive, qualitative research design was employed, which involved the use of standardized, semistructured interviews, conducted with the assistance of an interpreter who was fluent in several African languages. Setting Interviews were conducted outdoors in places in which traditional healers usually consult with their patients. These areas were in the fields close to the traditional healers’ homes or under a highway bridge in the Johannesburg inner city. Participants Individual interviews were conducted with 15 African traditional healers who had been practicing in their callings for at least 1 year. Results Traditional healers interviewed had treated one to six persons with a cleft lip, cleft palate, or both. Most informants believed that clefts were caused by the ancestors, spirits, and witchcraft. A variety of plant and animal products were used to treat these conditions and were augmented by spiritual resources from the ancestors. All except one healer had undergone formal training, although they had received no specific training relative to cleft lip and palate. Most participants reported referring patients to Western health care practitioners who were referred to as modern doctors but did not receive reciprocal referrals from these professionals. Patients generally consulted with traditional healers because this approach was part of their culture. Conclusions These findings have important implications for health care professionals as well as traditional healers in terms of cross-cultural consultation, collaboration, and information sharing with regard to cleft lip and palate; the potential use of traditional healers in primary health care and education; and further research.

Perceptions of the Impact of Speech, Language, Swallowing, and Hearing Difficulties on Quality of Life of a Group of South African Persons with Multiple Sclerosis

The present study investigated perceptions of speech, language, swallowing, and hearing difficulties and the relative impact of these problems on quality of life (QOL) in a group of South African persons with multiple sclerosis (MS). A questionnaire was used to elicit information regarding the difficulties experienced and the perceptions of their influence on QOL. Of the 30 respondents, 56.7% experienced speech problems and 63.3% reported language difficulties, with 62% of those feeling that these speech and language difficulties impacted on QOL. Fifty percent reported swallowing problems with 53% of those perceiving an influence on QOL. Twenty-three percent of participants experienced hearing problems with 44% expressing the view that their QOL was influenced. These findings are discussed with regard to their implications for the education and counselling of individuals with MS and their families, incorporation of speech-language pathologists and audiologists into management teams, and further research.

Reflections on the Cleft Experience by South African Adults: Use of Qualitative Methodology

OBJECTIVE This study explored the perceptions of a group of South African adults with repaired cleft lip, cleft palate, or both regarding their quality of life by considering the domains of communication, education, employment, family and marital life, social life, and emotional issues. DESIGN An exploratory-descriptive, qualitative research design was employed. SETTING Individual, semistructured interviews were conducted in the homes of participants. RESPONDENTS Twenty adults with repaired cleft lip, cleft palate, or both aged between 18 and 50 years participated in the study. RESULTS Participants were generally satisfied with their communicative abilities and perceived their speech to be intelligible. They also felt that speech therapy had improved the quality of their lives. Although they had experienced teasing during childhood, they did not feel that their cleft had affected their relationships with teachers and were generally satisfied with their educational attainments. Socially they reported being greatly affected by negative societal perceptions and prevailing cultural myths regarding etiology of clefts. Generally employment did not appear to be affected by the presence of a cleft. With regard to family life, participants reported being treated differently by parents in comparison with their siblings. For the majority of respondents, marital relationships and dating did not seem to be adversely affected. In terms of emotional factors, both positive and negative reactions were experienced in relation to the cleft. They also felt that the competent and compassionate care received from the multidisciplinary team had definitely enhanced the quality of their lives. CONCLUSIONS These findings have important clinical implications for a multidisciplinary approach to treatment; counseling of patients and their families; education of the community regarding cleft lip, cleft palate, or both; and further research.

Inaugural lecture: African spirituality, ethics and traditional healing - implications for indigenous South African social work education and practice

The over-reliance of South African social work on Euro-American and British theories, and the need to decolonise the profession, has long been recognised by many writers. This article endeavours to conceptualise a pluralistic, indigenous, Afro-centric model of social work education and practice that seeks to infuse the educational curriculum with African spirituality and ethics as well as traditional and Western approaches to helping and healing. However, the main thrust of the paper is that, while educational curricula need to be locally relevant, universities need to remain globally engaged.

A tale of two systems: beliefs and practices of South African Muslim and Hindu traditional healers regarding cleft lip and palate.

Objectives: This South African study compared the views of 15 Muslim and 8 Hindu traditional healers regarding the etiology and treatment of craniofacial clefts, reasons for people consulting with them, and collaboration with Western professionals. Data Analysis: The original data were collected via individual interviews. Secondary data analysis was conducted to highlight common themes. Results: Four Hindu and 12 Muslim healers believed that the condition was God sent. Both groups acknowledged the existence of various superstitions within their communities. For example, if a pregnant woman handled a sharp object during an eclipse, her infant could be born with a cleft. All Hindu healers also attributed clefts to karma. All the Muslim healers counseled patients and families. Fourteen referred people for medical help, 10 emphasized the importance of prayer, and 3 recommended the wearing of amulets containing a prayer. No Hindu healers provided direct treatment. Three advised parents to fast, six arranged fire and purification ceremonies in the temples, and three consulted the persons astrological chart to dispel any bad karma. Both groups of healers advised people to give to charity. Eight Hindu healers and eight Muslim healers believed that people consulted with them because of cultural influences and because they alleviated feelings of guilt. Four Hindu and 13 Muslim healers favored collaboration with Western practitioners. Conclusions: Findings highlight the need for culturally sensitive rehabilitation practices, collaboration, referrals, and information sharing between Eastern and Western health care practitioners.

Stipend-paid volunteers in South Africa: A euphemism for low-paid work?

Given the high unemployment rates in South Africa, the government has introduced policies to assist individuals to enter the job market, including stipend-paid volunteering. This research sought the views of stipend-paid volunteers and managers from four Johannesburg-based non-governmental organisations. The aims were to investigate whether stipend-paid volunteering was more like low-paid work than volunteering, the motivations for stipend-paid volunteering, the relationship between livelihood strategies and stipend volunteering, and the challenges and opportunities facing stipend-paid volunteers. It emerged that stipend-paid volunteers were initially motivated by extrinsic factors, such as the stipend, but later their volunteerism was sustained by intrinsic motivations, such as their community service orientation. While stipend-paid volunteering provided opportunities for training and experience, the work also presented challenges in terms of emotional stress, low remuneration and minimal support. Findings suggest that stipend-paid volunteerism would seem to be a euphemism for low-paid work.

Swallowing difficulties reported by adults infected with HIV/AIDS attending a hospital outpatient clinic in Gauteng, South Africa.

Objective: Swallowing difficulties can exert a profound effect on quality of life, may result in reduced nutritional intake and place individuals at risk of aspiration. However, there is little data available on the swallowing difficulties occurring within the HIV/AIDS population in South Africa. A descriptive study was therefore conducted to document the presence of reported swallowing difficulties in a sample of adults with HIV. Patients and Methods: One-to-one semi-structured interview schedules were administered to 120 adults with HIV attending a clinic in Gauteng, and medical records were evaluated to document the presence of reported swallowing difficulties. Results: Participants described a range of swallowing difficulties and the number of swallowing difficulties reported by participants was negatively correlated with CD4 count. Swallowing difficulties were significantly associated with various opportunistic diseases and related medical pathologies. Prescribed medications were associated with reported swallowing difficulties. Treatment of swallowing difficulties was mainly medical in nature. Swallowing difficulties had affected quality of life. Conclusions: From the results it was concluded that speech therapists have a role to play in the assessment and treatment of swallowing difficulties in individuals with HIV/AIDS.

Inequities in health outcomes and access to health care in South Africa: a comparison between persons with and without disabilities

Health is a fundamental human right and if health care is to be universal and equitable it should not be less accessible to some sectors of society than to others. The objective of this study was to compare health outcomes and access to health care between persons living with disabilities and their non-disabled counterparts. The research was based on secondary data analysis of wave 1 of the National Income Dynamic Survey. Results from the study indicated that people with disabilities reported a higher incidence of communicable and non-communicable diseases, lower access to medical insurance and greater use of public health care than their non-disabled counterparts. In conclusion, the findings highlight the inequities in health outcomes and access to health services for people with disabilities and emphasise the need for disability-friendly health care policies that reduce barriers to accessing health care.