STD/HIV/AIDS knowledge, beliefs and practices of traditional healers in Botswana.

The study investigated knowledge, beliefs, practices and experiences of traditional healers in relation to sexually transmitted diseases (STDs), HIV and AIDS. Traditional healers see about 70% of the African patients, with all kinds of ailments. The advent of HIV/AIDS and the introduction of home-based care in most African countries has increased the case-load of many traditional healers and increased the risk of contact with people living with HIV/AIDS. To protect themselves and their clients they need the right information on HIV/AIDS. Most traditional healers use their bare hands as a diagnostic tool and to apply topical medicine. Many traditional healers also utilize their mouths to suck blood from their patient's body as part of disease management. Most of the patients who are discharged from hospitals on home-based care usually end up at the traditional healer as relatives seek a second opinion or simply because they disagree with the diagnosis of incurable disease. This exposes traditional healers to HIV/AIDS. The study showed that traditional healers have some practices and beliefs, such as the use of the mouth for sucking blood (blood-letting), use of sharp instruments which is risky behaviour and the belief that HIV/AIDS is not a new disease. Further most of the traditional healers did not have adequate and in some cases correct information on HIV/AIDS. A few even believed they could cure AIDS as it has always been a disease they have been dealing with and were adamant it is not a new disease. Rapport between traditional healers and scientific medical personnel is essential for an effective and successful HIV/AIDS prevention and control programme.

The role of culture in primary health care. Two case studies.

The purpose of this article is to show the importance of traditional healers in primary health care (PHC) services. Most countries, despite adopting PHC, have not incorporated traditional healers into this service. The article also illustrates how traditional healers fulfil three of Morrell's four PHC objectives, and how incorporating traditional healers into health services will fulfil the fourth objective. The first contact between a black African patient and health care services usually takes place in the traditional healing system. Therefore health workers should realise that the traditional care system is important if PHC is to succeed. Traditional healers are the most important primary health care service in an African setting. This is highlighted by 2 cases described in the article.

Attitudes of women towards traditional midwives--a survey in the Kgalagadi (Kalahari) region.

Two hundred and forty-nine women of childbearing age from 20 villages in the Kgalagadi (Kalahari) desert region, who had borne a child, were asked about their attitudes towards institutional and non-institutional deliveries. Two hundred and two (81.6%) women preferred to give birth at home. One hundred and seventeen (46.9%) attended antenatal clinics at health facilities but virtually none of these attended postnatal clinics. Forty-one per cent of the women who prefer to give birth at home do so because at home they receive African 'muti' and an abdominal massage; 22.5% deliver at home because they feel it is safer and more convenient. Most African women and communities are reluctant to entrust the sluicing of their placenta and other products of conception to strangers such as nurses. Ninety per cent of respondents suggested that traditional midwives and health personnel should work together to improve community maternal health services.

The anthropology of burns in Zimbabwe

Burns; especially of children are the most common severe household accidents and are almost always preventable. In Zimbabwe the most common aetiology of burns is scalding. The purpose of this article is to show the relationship between the incidence of burns and socio-economic status; by comparing the burns occurring in high-density and rural areas (poor environment) with those occurring in low-density areas (affluent environment)

Attitudes of males on contraception: a KAPE survey.

Acceptance of Family Planning services has been at a very slow pace in Africa. It was generally believed that the African male, due to his conservatism, was an obstacle to the acceptance of contraception by the African female. The study however showed that this was not true. The attitude of the African male towards contraception has changed drastically during the last thirty years, from ultra-conservatism during the 60s to very liberal in the 80s and 90s. Further it can be said that the African male is as well informed and has the same degree of Family Planning and child spacing acceptance-level as his counterpart in the developed world. However the African male does not accompany his partner for Family Planning Counselling. The study showed that most African men associate Family Planning with the use of condoms and not other methods such as the pill or the intrauterine devices.

PIP: A research field assistant interviewed 260 men living in villages in Kgalagadi (Kalahari) district in Botswana to determine their acceptance of family planning (FP). 74% knew something about FP and 81.2% knew that the health facility provided FP services. While women in another survey in the same district were more likely to report a health worker as the first person to tell them about FP (86.3%), men were more likely to mention friends, family, and others (69.9%). Most men (75%) discussed FP with their partners. Just 13.5% went with their partners to FP counseling sessions. 36.5% believed contraceptives encourage infidelity and would be so angry if their partners were using contraceptives that they would beat them. Only 35.4% said that only women should practice FP. 30.8% considered prevention of transmission of sexually transmitted diseases to be a man's duty. 33.8% said that both men and women should cooperate in FP. 78.5% considered too many children for their partners as not good, but for financial reasons, not health reasons. 51.9% wanted more than 3 children. 88.4% believed contraceptives were safe. Most men linked condoms to FP. 45.7% consistently used condoms. 86.2% wanted their partners to use FP while the other believed it to be against biblical teachings. Only 6.9% would ever think about having a vasectomy. Just 20.8% knew about female surgical sterilization. In conclusion, most men knew about and accepted FP. FP workers must step up promotion of male attendance at FP counseling sessions. They also need to inform men that other FP methods besides condoms exist.

Prevention of sexually transmitted disease. The Shurugwi sex-workers project.

Sex-workers play an important role in the spread of sexually transmitted diseases (STDs) and this article tries to show that they can also play an important role in their prevention. Community participation by sex-workers in the prevention of STDs can also decrease the incidence thereof.

Abdominal deliveries in Africa: food for thought to scholars of the history of medicine.

The purpose of this article is to show the advancement in knowledge of cesarean sections among African traditional healers before the advent of colonialism and introduction of scientific medicine (allopathy) to Africa. The case mentioned below was witnessed by Robert W. Felkin, a Scottish medical anthropologist, in Uganda in 1879. Felkin subsequently wrote a medical dissertation on his observations, which he submitted to Marburg University, Deutsche Reich (now Federal Republic of Germany), in 1885.

PIP: Robert Felkin, a Scottish medical anthropologist in Uganda in 1879, observed African medical achievements and used this information to write his medical dissertation. Caesarian sections have been performed since the reign in Rome of Numa Pompilius (715-672 B.C.), mainly on women who died late in pregnancy. The 1st Caesarian on a live patient was performed in 1610. Most patients (85%) died of hemorrhage or infection until 1882 when Sanger introduced longitudinal incision and uterine fundus sutures which greatly decreased the risk of hemorrhage. Poro introduced sterile surgical methods and decreased the risk of infection. Caesarians were performed in Africa much before colonization. A story of an abdominal delivery as performed by an African operator, is related in detail. Another incident of a black slave in America in 1869 performing abdominal surgery on herself is briefly mentioned. It is clear from the stories that medical knowledge was fairly advanced in Africa: cauterization of the bleeding points with a hot iron was used, dressing with a poultice to decrease risk of infection was standard, closing the incision with animal gut sutures, post operative suture removal, "anesthesia" with wine, and scrubbing with alcoholic beverages were all techniques used that are strikingly similar to "modern" surgical techniques.