RESUMO
BACKGROUND: Patients from Aruba, Bonaire and Curacao are often inclined to attribute mental problems to brua, the Dutch-Antillean counterpart of voodoo. Because little is known about brua and patients are usually reluctant to talk about it, problems can arise in the communication with biomedically trained health practitioners. AIM: To provide an overview of the literature on brua, and of the ways in which brua may interfere with the diagnosis and treatment of Dutch-Antillean patients with mental health problems. METHOD: We searched the literature via PubMed and Embase (up to October 2012) and the historical literature (from 1880 onwards) written in Dutch, English, French, Spanish, and Papiamento. RESULTS: Brua has its origins in folk medicine and magico-religious rituals, which are regarded both as the cause of and a cure for mental illness. Although Antillean patients generally turn to medically trained professionals when they are confronted with medical problems, they often rely on brua medicine when they face either simpler problems, or problems for which Western medicine cannot provide a solution. CONCLUSION: On the basis of the literature, the area of tension between the Western approach to medicine and the brua approach seems to be insignificant, except perhaps in cases where hallucinogens or other psycho-active substances complicate the clinical picture and in cases where the patient's fear for sorcery dominates clinical symptomatology.
