The role of forest in the knowledge production of traditional medication in Tejang Village Sebesi Island, South Lampung

Forest has a crucial role in elevating public welfare. It provides various products such as food, beverages, clothes, residence, musical instruments, and medicines. The medicines originated from the forest could act as the supplier for livelihood particularly for a traditional healer. The traditional healer is one of the health treatments sources for the people of Sebesi Island. For traditional healers, the forest is also beneficial in the knowledge production of traditional medication. This study purposes to examine the role of the forest in knowledge production carried out by traditional healers and identify the patterns of knowledge production. Data collection was done through interviewing, involving four traditional healers in Tejang Village, Sebesi Island, South Lampung. Another method was literature study related to the roles of forests in traditional medication and knowledge production. The knowledge production process can occur through giving agents, both human and non-human ones, namely teachers, family members, books, and dreams. The interaction between those healers with the forest also resulted in the medication knowledge. The role of the forest in the knowledge production of traditional medication is that it transforms into a place for semedi or meditation when doing ngelmu, knowledge sources about medication, and the place for the existence of medicinal plants.

Survey of the Use of Traditional and Complementary Medicine (T&CM) Among Children with Cancer at three hospitals in Cameroon.

Introduction There is lack of diagnostic and treatment resources with variable access to childhood cancer treatment in low- and middle-income countries (LMIC), which may lead to subsequent poor survival. The primary aim of this study is to determine the prevalence and types of T&CM used in Cameroon. Secondarily, we explored determinants of T&CM use, associated costs, perceived benefits and harm, and disclosure of T&CM use to medical team. Method A prospective, cross-sectional survey amongst parents and carers of children younger than 15 years of age who had a cancer diagnosis and received cancer treatment at three Baptist Mission hospitals between November 2017 and February 2019. Results Eighty participants completed the survey. Median patient age was 8.1 years (IQR4.1 – 11.1). There was significant availability (90%) and use (67.5%) of T&CM, while 24% thought T&CM would be good for cancer treatment. Common T&CM remedies included herbs and other plant remedies or teas taken by mouth, prayer for healing purposes and skin cutting. Living more than 5 hours away from the treatment center (p=0.030), anticipated costs (0.028), and a habit of consulting a traditional healer when sick (p=0.006) were associated with the use of T&CM. T&CM was mostly paid for in cash (36.3%) or provided free of charge (20%). Of importance was the fact that nearly half (44%) did not want to disclose the use of TM to their doctor. Conclusion Pediatric oncology patients used T&CM before and during treatment but would be unlikely to disclose to the child’s health care team.

Christ’s Seer Office in the South Sudanese Context

Christ's Seer Office (CSO) has a hotchpotch of controversies encompassing it. Among these polemical trajectories that obtains in these controversies is the African’s prophetic office. This is certainly due to the close parallelism that CSO matches the prophetic office of Christ. In the South Sudanese context, some African communities view Christ as a magician, medicine practitioner, or a traditional healer. This misconception should not be taken lightly. It needs a deeper introspection from the African Christian theologians, as the concerned communities may abandon the church and revert to their ancestral shrines for worship. The Nuer in South Sudan has embraced prophet Ngundeng as their Christ just because of some similarities that exist between Christ’s Seer Office and Ngundeng. This article fully reconnoitered the two prophetic offices by comparing them by using the principle of Nexus mysteriorum and Analogia entis to enhance the Nuer understanding of Christ. In its findings, this article reveals Christ as a prophet; the whom all the Old Testament prophets prefigured in their speeches and actions. Moreover, the study concluded that Jesus is Nuer’s Ngundeng par excellence.

DEDUCTIBLE MEDICAL EXPENSES FOR INCOME TAX PURPOSES: TRADITIONAL HEALERS, PHARMACISTS AND COSMETIC PROCEDURES

In terms of section 18(1)(b)(i) of the Income Tax Act 58 of 1962 a taxpayer is entitled to a qualifying medical-expenses deduction for services rendered by a registered medical practitioner specifically listed in subparagraph (i). Since the promulgation of the Traditional Health Practitioners Act 35 of 2004 and the later Traditional Health Practitioners Act 22 of 2007 (which replaced the earlier unconstitutional act), section 18(1)(b)(i) has not been amended to provide a qualifying medical-expenses deduction to a taxpayer who consulted a traditional healer instead of a medical practitioner as listed in subparagraph (i). This article attempts to show that no suchamendment is needed. The taxpayer can avail himself of the burden of proof to make a qualifying medical-expenses deduction for services rendered by a traditional healer by applying an expansive interpretation to the words “medical practitioner”. This article furthermore discusses the interpretation problems as a result of the vague meaning of “professional services” and the subsequent possibility to deduct cosmetic expenses as qualifying medical expenses. Lastly, this article discusses the situation where a taxpayer wishes to make a qualifying medical-expenses deduction for schedule 2 medicines prescribed and supplied by a pharmacist, which, it seems, is not allowed.

Clinical and sociodemographic factors associated with late stage cervical cancer diagnosis in Botswana

Background Cervical cancer is the leading cause of female cancer mortality in Botswana with the majority of cervical cancer patients presenting with late-stage disease. The identification of factors associated with late-stage disease could reduce the cervical cancer burden. This study aims to identify potential patient level clinical and sociodemographic factors associated with a late-stage diagnosis of cervical cancer in Botswana in order to help inform future interventions at the community and individual levels to decrease cervical cancer morbidity and mortality. Results There were 984 women diagnosed with cervical cancer from January 2015 to March 2020 at two tertiary hospitals in Gaborone, Botswana. Four hundred forty women (44.7%) presented with late-stage cervical cancer, and 674 women (69.7%) were living with HIV. The mean age at diagnosis was 50.5 years. The association between late-stage (III/IV) cervical cancer at diagnosis and patient clinical and sociodemographic factors was evaluated using multivariable logistic regression with multiple imputation. Women who reported undergoing cervical cancer screening had lower odds of late-stage disease at diagnosis (OR: 0.63, 95% CI 0.47–0.84) compared to those who did not report screening. Women who had never been married had increased odds of late-stage disease at diagnosis (OR: 1.35, 95% CI 1.02–1.86) compared to women who had been married. Women with abnormal vaginal bleeding had higher odds of late-stage disease at diagnosis (OR: 2.32, 95% CI 1.70–3.16) compared to those without abnormal vaginal bleeding. HIV was not associated with a diagnosis of late-stage cervical cancer. Rural women who consulted a traditional healer had increased odds of late-stage disease at diagnosis compared to rural women who had never consulted a traditional healer (OR: 1.61, 95% CI 1.02–2.55). Conclusion Increasing education and awareness among women, regardless of their HIV status, and among providers, including traditional healers, about the benefits of cervical cancer screening and about the importance of seeking prompt medical care for abnormal vaginal bleeding, while also developing support systems for unmarried women, may help reduce cervical cancer morbidity and mortality in Botswana.

Is It AIDS? Or Is It Kaliondeonde? Preliminary Assessment of an Indigenous AIDS-like Illness in Zambia

Background: Kaliondeonde is an AIDS-like immunosuppressive illness of unknown etiology common in Zambia and Malawi. It has similar, but not identical, symptoms to HIV/AIDS, and appears to have been in south central Africa longer. It is often viewed by both the public and academics as being the same as HIV/AIDS. Method: Research was conducted in Zambia among seven kaliondeonde patients to determine the perceptions of the sickness, and the symptoms of the disease, in comparison with HIV/AIDS. A subset of four of the patients were examined by both a traditional healer and a physician, and tested for HIV. Results: Two of the four kaliondeonde patients were found to be HIV negative, suggesting the possibility that kaliondeonde is different from HIV/AIDS. Conclusions: If future research confirms that many kaliondeonde patients are in fact HIV-negative, it will become vitally urgent to clarify the distinctiveness of the two illnesses and alter perceptions and knowledge of kaliondeonde prevention, epidemiology, etiology, and clinical practices.

People with amputations in rural Sierra Leone: the impact of 3D-printed prostheses

We report the case of a man with a transhumeral amputation in a rural area of Sierra Leone. The patient had fractured his humerus during a football match. Due to lack of transportation and medical centres nearby, the patient was seen by a traditional healer. Although the traditional healer expected the fractured bone to heal within 3 days, the open fracture became infected. This finally resulted in a transhumeral amputation. The patient began to have a lack of self-confidence and felt excluded from society. He could not afford a conventionally fabricated prosthesis. Fourteen years later, the patient received a lightweight three-dimensional-printed arm prosthesis developed at the Masanga Hospital. The patient was very satisfied because the prosthesis met his criteria of aesthetics and functionality. His story highlights the socioeconomic hardship of being a person with an amputation in Sierra Leone and the need for affordable technological solutions.

Traditional and biomedical care pathways for mental well‐being in rural Nepal

Background There is increasing access to mental health services in biomedical settings (e.g., primary care and specialty clinics) in low- and middle-income countries. Traditional healing continues to be widely available and used in these settings as well. Our goal was to explore how the general public, traditional healers, and biomedical clinicians perceive the different types of services and make decisions regarding using one or both types of care. Methods We conducted in-depth interviews using a pilot tested semi-structured protocol around the subjects of belief, traditional healers, and seeking care. We conducted 124 interviews comprising 40 traditional healers, 79 general community members, and five physicians. We then performed qualitative analyses according to a grounded theoretical approach. Results A majority of the participants endorsed belief in both supernatural and medical causes of illness and sought care exclusively from healers, medical practitioners, and/or both. Our findings also revealed several pathways and barriers to care that were contingent upon patient-, traditional healer-, and medical practitioner-specific attitudes. Notably, a subset of community members duplicated care across multiple, equally-qualified medical providers before seeing a traditional healer and vice versa. In view of this, the majority of our participants stressed the importance of an efficient, medically plural society. Though participants desired a more collaborative model, no consistent proposal emerged on how to bridge traditional and biomedical practices. Instead, participants offered suggestions which comprised three broad categories: (1) biomedical training of traditional healers, (2) two-way referrals between traditional and biomedical providers, and (3) open-dialogue to foster mutual understanding among traditional and biomedical providers. Conclusion Participants offered several approaches to collaboration between medical providers and traditional healers, however if we compare it to the history of previous attempts, education and understanding between both fields may be the most viable option in low- and middle-income contexts such as Nepal. Further research should expand and investigate opportunities for collaborative learning and/or care across not only Nepal, but other countries with a history of traditional and complimentary medicine.

MENJAGA SEHAT, MENJAGA ADAT PRAKTIK PENGOBATAN TRADISIONAL TUMPUROO DAN PELESTARIAN ADAT DI HUKAEA-LAEYA

The Hukaea-Laeya community has been established as a customic village inhabited by the ethnic of Mororene who still strongly believe in tumpuroo whose function is as a traditional healer. In terms of medical treatment, even until nowadays the people of Hukaea-Laeya still place a great trust in tumpuroo. The existence of tumpuroo is very closely related to the preservation of Moronenean traditional culture and health. This paper aimed to explain the traditional practices of tumpuroo with various values ​​and perspectives and their influence on the preservation of tradition, especially spells. The study was conducted with the ethnographic method in Hukaea-Laeya with data collection techniques through observation and in-depth interviews. From the data analysis, it could be explained that tumpuroo had a strategic role in protecting Moronenean's public health from illness and disease. On the other hand, tumpuroo also became important actors in the effort to preserve local wisdom stored in medical spells. Moreover, when the concept and worldview about health was also connected with the process of preserving customs related to ancestral spirits and the transcendental figures. The social health role of the tumpuroo could be enhanced by the government to encourage the promotion and development of health based on the capacity of local communities.