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Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal.

ABSTRACT: To explore the relationship between traditional healers and conventional psychotherapy, we conducted a combined ethnographic study and structured observational rating of healers in the middle hill region of central Nepal. We conducted in-depth interviews and ethnographic observations of healing with 84 participants comprising 29 traditional healers and 55 other community members. Overall, our observations and participant responses yielded a range of interventions that improved health through belief, satisfaction in the soul, social support, transference, and symbolic narration. The findings from our overall ethnography suggest that healers offer a platform for their patients to accept a disease state, cope with it, and to experience palliation of distress. We additionally focused on one participant who saw multiple healers for a case study, during which we rated healing behavior using an observational measure of empathy, emotional validation, and therapeutic alliance. Using this measure, healers who were perceived as successful, scored high on alliance, empathy, promoting expectations of recovery, and use of cultural models of distress. The results of our structured observation suggest healers draw upon processes also observed in psychotherapy. Further research is needed to explore if these practices can be generalized to healers in other parts of Nepal and other settings. [spirituality, mental health, ethnopsychology, shamanism, mind-body relations].

SUBMITTER: Pham TV

PROVIDER: S-EPMC7531438 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal.

Pham Tony V TV Koirala Rishav R Kohrt Brandon A BA

Ethos (Berkeley, Calif.) 20200301 1

To explore the relationship between traditional healers and conventional psychotherapy, we conducted a combined ethnographic study and structured observational rating of healers in the middle hill region of central Nepal. We conducted in-depth interviews and ethnographic observations of healing with 84 participants comprising 29 traditional healers and 55 other community members. Overall, our observations and participant responses yielded a range of interventions that improved health through bel ...[more]

PMID: 33012879

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Project description:BackgroundSnakebite is a neglected tropical disease (NTD) affecting rural and remote populations globally, who are additionally burdened by poverty and the lack of effective healthcare systems. Delayed healthcare and use of traditional treatments are very frequent. The purpose of our study was to explore perceptions of snakes, impact of snakebite, and knowledge and opinions of different snakebite treatments with the aim of identifying opportunities for improving snakebite management.MethodsThis is a qualitative descriptive study based on semi-structured interviews with 21 snakebite victims and 4 traditional healers in 4 villages of Akonolinga health district, Center Region, Cameroon. Analysis focused on describing participants' perceptions of snakes, the impact of snakebite on the victims' lives, and their opinions of different treatment options.ResultsRespondents were fearful of snakes and knowledgeable about envenoming symptoms and treatments. The experience of snakebite led to increased vigilance and avoidance behaviours, which sometimes resulted in financial loss for the victims. A range of traditional treatments were described, including tourniquets, black-stone application and medicinal plant decoctions. However, opinions were ambivalent regarding their efficacy, depending especially on previous personal experiences. Still, traditional treatments were said to be more available and cheaper than hospital care, and in particular, than antivenom. Nevertheless, most victims preferred hospital treatment if the financial and transportation barriers were lifted. Both snakebite victims and traditional healers were of the opinion that collaboration between health services and traditional healers could help to improve snakebite management and outcomes.ConclusionOur study shows that snakebite victims are in favour of using antivenom for the treatment of snakebite and would welcome better access to it. However, its current unavailability and high cost pushes them to turn to traditional treatments. On the other hand, traditional healers are in favour of collaborating with health facilities. These results are very encouraging for the improvement of snakebite management in Cameroon along the lines of the WHO Snakebite Envenoming Strategy for Prevention and Control: ensuring access to safe and effective treatment, and increasing partnership and coordination between communities, traditional healers, and conventional caregivers.

Project description:BackgroundTraditional healers are acceptable and highly accessible health practitioners throughout sub-Saharan Africa. Patients in South Africa often seek concurrent traditional and allopathic treatment leading to medical pluralism.Methods & findingsWe studied the cause of five traditional illnesses known locally as "Mavabyi ya nhloko" (sickness of the head), by conducting 27 in-depth interviews and 133 surveys with a randomly selected sample of traditional healers living and working in rural, northeastern South Africa. These interviews were carried out to identify treatment practices of mental, neurological, and substance abuse (MNS) disorders. Participating healers were primarily female (77%), older in age (median: 58.0 years; interquartile range [IQR]: 50-67), had very little formal education (median: 3.7 years; IQR: 3.2-4.2), and had practiced traditional medicine for many years (median: 17 years; IQR: 9.5-30). Healers reported having the ability to successfully treat: seizure disorders (47%), patients who have lost touch with reality (47%), paralysis on one side of the body (59%), and substance abuse (21%). Female healers reported a lower odds of treating seizure disorders (Odds Ratio (OR):0.47), patients who had lost touch with reality (OR:0.26; p-value<0.05), paralysis of one side of the body (OR:0.36), and substance abuse (OR:0.36) versus males. Each additional year of education received was found to be associated with lower odds, ranging from 0.13-0.27, of treating these symptoms. Each additional patient seen by healers in the past week was associated with roughly 1.10 higher odds of treating seizure disorders, patients who have lost touch with reality, paralysis of one side of the body, and substance abuse. Healers charged a median of 500 South African Rand (~US$35) to treat substance abuse, 1000 Rand (~US$70) for seizure disorders or paralysis of one side of the body, and 1500 Rand (~US$105) for patients who have lost touch with reality.ConclusionsWhile not all healers elect to treat MNS disorders, many continue to do so, delaying allopathic health services to acutely ill patients.

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Project description:Traditional healers in Thailand are a primary source of health care for the Thai people. Highly experienced traditional healers are generally older people and they continue to pass away without recording or passing on their knowledge. Consequently, the cumulative knowledge held by traditional healers regarding the use of medicinal plants is being eroded and could be lost. In this study, we aimed to identify and document the medicinal plants and associated ethnobotanical knowledge held by traditional healers in Roi Et in northeastern Thailand. Data and plant specimens were collected from four traditional healers of the Phu Tai people. They were selected by purposive sampling and questioned using a semi-structured interview. The interviews covered their training, the ailments treated, treatment techniques, method of preparation and in addition, several healing sessions were observed. During field walks, we searched for the medicinal plants with the healers to review and document the availability of medicinal plants at each locality and in different habitats around the villages. Use values (UV) were calculated to estimate the importance of each medicinal plant and informant agreement ratios (IAR) were calculated to understand how widely known the uses were. The four Phu Tai traditional healers knew 162 medicinal plant species in 141 genera and 63 families. The family with the most medicinal plants was Leguminosae with 15 species. The plant part that they used most commonly was the stem, which was used for 82 species (49%). The most common preparation method was decoction, which was done for 124 species (75%). The most important and widely used medicinal plants were Rothmannia wittii, which had the highest use value (UV = 1.7). Most medicinal plants were used for treating tonic (34 species (21%)). Jaundice had the highest informant agreement ratio (IAR = 0.5). The most common life form among the medicinal plants was trees (56 species (34%)). The medicinal plants were mostly collected in community forests (81 species (49%)). Considering the richness of the healer's pharmacopeia, and the fact that their profession is not being perpetuated, this study points to the urgent need to document the traditional knowledge from the old herbalists before it disappears with the last practitioners from rural communities in Thailand.

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Dataset Information

Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal.

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Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal.

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