Caring for people with HIV in Zambia: are traditional healers and formal health workers willing to work together?

This study of traditional healers and formal health workers determined their knowledge and practices in the field of HIV/AIDS and examined their training needs and attitudes to collaboration, in preparation for planning joint training workshops. Several misconceptions concerning symptoms and transmission of HIV disease were found in both groups, particularly among traditional healers. Twenty healers (51%) and four formal health workers (15%) claimed a cure existed for AIDS. The majority of traditional healers interviewed expressed difficulties discussing a diagnosis of HIV directly with patients, mainly due to fear of the patient becoming depressed and suicidal. Most interviewees wanted more training--the majority of traditional healers in recognizing symptoms of HIV/AIDS and their treatment, and the majority of formal health workers in HIV counselling. Most were interested in supplying condoms. Almost all healers and half of the formal health workers were keen to collaborate in training and patient care. The study indicates that there is willingness amongst Zambian traditional healers and formal health workers to collaborate in training and patient care in the field of HIV/AIDS. As well as covering symptoms, transmission and prevention of HIV/AIDS, training should aim to increase ability to openly discuss HIV with patients, which many traditional healers and some formal health workers find difficult. Involving traditional healers in supplying condoms may improve acceptability and availability, particularly in rural areas.

PIP: A knowledge questionnaire and a semistructured interview was conducted with 39 traditional leaders (22 males and 17 females) and 27 formal health workers (4 men and 23 women) to determine their knowledge and practices in the field of HIV/AIDS; additionally, their training needs and attitudes to collaboration, in preparation for planning joint training workshops, were examined. Areas explored included symptoms and transmission of HIV/AIDS, treatment, personal risk, condom use and distribution, traditional practices, education and prevention, HIV counseling and testing and collaboration between healers and health workers. Results showed that misconceptions and gaps concerning transmission and symptoms existed in both groups, particularly among the traditional healers. 20 traditional healers (51%) and 4 formal health workers (15%) claimed that a cure for AIDS existed. Most health workers and traditional healers found discussing a diagnosis of HIV directly with patients difficult because of fears that it might make them depressed or suicidal. However, many healers were keen to participate in condom distribution. There was more support for collaboration among traditional healers than among formal health workers; almost all formal health workers but only 8 traditional healers knew of voluntary HIV counseling. Both traditional healers and formal health workers have significant and complementary roles in the field of HIV/AIDS in Zambia, but there is much debate concerning the relationship between them.

Forging links between the formal and traditional in Zambia. Special report: traditional healers.

PIP: Many Zambians seek help concurrently from traditional healers and formal health services. For example, a study at the University Teaching Hospital in Lusaka found that more than 75% of inpatients had also sought advice from traditional healers. A second study of 1000 patients seen at Kara Counseling and Training Trust (KCTT) in Lusaka found that 68% of those attending for HIV counseling and testing had seen a traditional healer. The importance of involving traditional healers in HIV prevention programs has not, however, been recognized in Zambia. Several traditional healers have approached KCTT requesting help in managing patients who they suspect may be HIV-seropositive, especially for HIV testing. Many of the organization's counselors and medical staff recognize the role which traditional healers have in caring for HIV-infected individuals, but some are concerned that traditional medicines are ineffective and that traditional healers are disseminating inappropriate health education messages. 68 of 101 counselors surveyed in Lusaka nonetheless expressed an interest in working more closely with traditional healers.^ieng