RESUMO
Traditional medicinal knowledge and healing practices of indigenous spiritual healers play important roles in health care, and contribute towards achieving Universal Health Care. Traditional spiritual healers (TSHs) are grouped into three categories. One category of Baganda TSHs, Balubaale, engage ancestral spirits during health management. Balubaale are socially significant but not legally accepted. Their initiation and training practices have not been documented in Uganda. The study purpose was to understand and establish the training of traditional spiritual healers. Twelve (10M, 2F); practicing TSHs in Central Uganda were purposively selected and recruited between 15th July 2019 and 29th April 2020, and were prospectively interacted with for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software and presented based on an inductive approach. Findings show key areas of TSHs training include connecting with ancestral spirits and the spiritual powers of non-materials and materials such as living and non-living things through rituals. Spiritual healers train in diagnosis and health management based on ancestral spirits and they finally pass out in a communal ceremony witnessed by family and community members. We conclude that TSHs undergo training and are supervised and supported by experienced spiritualists, family and the community. We recommend similar studies among other ethnic groups to contextualize the process of becoming a TSH, compare and harmonize findings to facilitate inter-medical systems communication and policy considerations.
RESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: The aim of the survey was to document medicinal plants used in malaria treatment by Prometra (Promocion de la medicina tradicional amazonica) Traditional Medical Practitioners (TMPs) of Uganda and for search of new antiplasmodial herbal medicines (HMs) for further phytochemical analysis. MATERIALS AND METHODS: In this study, semi structured guided open and close ended questionnaires were used. Focus group discussions were conducted and key informants were chosen within the TMPs who helped in further discussions of how the herbal remedies where collected, prepared and administered. RESULTS: A sample size of 51 respondents was randomly selected among the TMPs with the help of their leader. 86 species distributed over 81 genera and 39 families were reportedly being used as herbal remedies in malaria treatment. The TMPs use symptoms like high temperature, shivering, among others in malaria diagnosis an indication that they understand malaria. They emphasized the use of leaves and bark in treatment because they can regenerate and therefore ensure sustainable use of plants rather than the use of roots which would be destructive. These TMPS treat and also advise their patients on preventive measures against malaria attacks like sleeping under mosquito nets, clearing bushes near homesteads, among others which is an indication that they help in the prevention and mitigation of malaria incidences and prevalence in the areas where they live. The Informant Consensus Factor (FIC) value of 0.8 demonstrated that the TMPs of Prometra-Uganda tend to agree with each other in terms of the plant species they use in malaria treatment an indication of quality control in as far as administration of the herbal remedies. Vernonia amygdalina Delile, Bidens pilosa L., Justicia betonica L. were highly cited as being used in malaria treatment with frequencies of mention of 38, 28 and 25, respectively. CONCLUSION: TMPs of Prometra-Uganda understand and treat malaria using the available plant diversity from their huge forest and the herbal gardens within Buyija forest. The healers are very keen at plant conservation which is a good practice. Species like Justica betonica may be investigated further for antiplasmodial assays to justify its efficacy.
