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Spirituality and religion are not new facets of health and medical care in traditional African culture and society. Since the inception and establishment of these cultures, healing practices and rituals were performed with a focus on the spirit to create better overall health for the patient, or in contrast, wreak havoc on the body and soul of an adversary. Through the Diaspora, these techniques transcended time and continent and became an important part of African-American culture and their choices regarding medical care and treatment. The seemingly unwelcome introduction of modern Western medical techniques with a greater focus on the bio, or body, interrupted these traditional practices focused on the spirit and mind in an effort to provide better care based on a set of social criteria not applicable to the culture or region. Indigenous healing is known as the practices and knowledge that existed before the invention of modern medicine that were used to promote, maintain and restore health and well being (Harley). The increased and rapid spread of the HIV virus to the African and African-American communities demanded that Western medical techniques be incorporated into a patients' care. Traditional African based medicine was ineffective against this particular opponent and myths that sexual intercourse with a virgin could affect its cure actually did more harm than good. Traditional techniques with African origins used in the past to heal and treat conditions have been relegated to mere myth or folklore, as opposed to being a part of blended care, or total care for the patient.
1) traditional medicinal healing and practices offer a more spiritual or religion centered focus. These techniques embody the concept that the mind, body, soul and spirit are one and must therefore be treated medically as such (Anandarajah).
2) traditional medicinal healing and practices involving African techniques offer a more patient and family centered approach to care when compared with Western medical techniques (Harley).
3) traditional medicinal techniques based on various African cultures and ethnicities are clearly more cost effective (Harley).
Although seen across the globe, these changes are clearly taking place in America, as persons of African descent seek to embrace their culture and ethnicity from a medicinal perspective.
When embracing these traditional African methods of healing and medicine over a more contemporary point of view, one must ask, "What role does ones culture, religion, and spiritual view play in their medical choices and subsequent healing process, especially when embracing traditional African healing and medicinal practices, and how are these practices different"? This paper will explore the healing and medicinal practices and choices of African-Americans based on religion and spirituality from a Christian and Yoruba perspective, as well as address these belief systems and their impact on healing and medicine, and medical choice in the African-American community.
"Lay Thy Hands On Me" - Perspectives on the Role of Religion and Spirituality in Medical Care and Choice Affecting African Americans
In recent years the place of spirituality in hospital organizations and medical care and choice has become increasingly discussed and advocated (David R. Graber) across the globe. Spirituality, also called religiosity or religiousness is considered by many that embrace any religious perspective to be essential in the healing process and inherent in African-American culture (Harley). Also theorized, especially in the African-American community, is the perspective that denial of a spiritual component and not nurturing its needs when addressing issues of health can be detrimental and deter, alter or end the healing process (Sawandi). Western medicinal practices historically did not directly address issues of spirituality in medical practices or medical choice. When utilizing the current bio-psycho-social model to treat illness and disease, religion played a minor role in medical choice, but had greater influence among hospitals that were Christian based, such as Catholic, Presbyterian, and Lutheran (Lyn Schumaker). A plethora of evidence in the last decade supporting the incorporation of spirituality in whole-person patient medical care has promoted clinicians and practitioners to evolve to a bio-psycho-social-spiritual model for better overall health (Anandarajah) and patient care.
We are in the midst of a global health crisis with chronic diseases impacting the African-American community in larger numbers than other cultures (Centers for Disease Control and Prevention). Often overlooked in the modern medical community is the role of indigenous healing, especially techniques with African origins and the potential positive impact they can have to the healing process (Harley). The origins of indigenous healing with African roots can be traced back to 1619 when slaves were brought to the United States in large numbers. Harley asserts:
"Slaves preferred self-treatment or treatment by friends, older relatives or conjure doctorsâ€¦â€¦.Religion was and is interwoven into health care beliefs and practices from that time, possibly to the presentâ€¦â€¦.African healing practices are methods, techniques and materials that they use as a result of their heritage and relocation to the New World to heal, cure and respond to physical, medical and emotional conditions and their psychological circumstances" (Harley, 435).
Unfortunately in the United States, indigenous healing practices are traditionally linked to Native Americans, Mexican and Native Hawaiian cultures which may not be historically accurate. Medicinal techniques and indigenous healing with roots in African culture have traditionally been excluded from this definition (Harley). Persons of African descent meet the definition of indigenous people due to the Diaspora, the displacement of African people into a land different from their own (Lyn Schumaker), and their continued survival. Although these people were in a foreign land, they brought with them customs of healing and medical techniques far different and possibly more effective than Western medicine and culture. This knowledge was forged with spiritual techniques to create an environment of healing, one that is still inherent in its people and that still exists today.
Within the African-American community, the application of indigenous healing includes "gifted" people within this specific culture who provide various forms of healing and guidance to those that seek intervention for particular problems, both mental and physical (Harley). These practices include interventions ranging from herbal medicines and salves to therapeutic touch and prayer, either alone or collectively in groups (Lyn Schumaker). Additionally within the African-American community, 80 percent of people report believing that God supernaturally heals people in answer to prayer (Brown), this presents strong evidence that spirituality, religiousness or a belief in God or a higher power is responsible for healing and a cure and thus has the potential to impact medical choice and care within the African-American community and collectively will be used in conjunction with modern medicinal techniques. Additionally, indigenous medicinal practices are commonly recognized as regularly occurring in African-American culture (Harley). For African-Americans seeking medical care and treatment with indigenous roots in African culture, they do so because these methods are holistic and are based on knowledge of self rather than context. In short this is evidence to support the theory that healing and medicine with African roots embodies "whole person" care as opposed to treating a specific illness or disease (Sawandi) and is a compelling reason to select it as the preferred method of treatment or standard of care alone of in conjunction with contemporary Western medical techniques.
Traditional Choices and Standards of Care Based on Religious Practices - Yoruba
The Yoruba tradition embodies a series of gods or orishas that are responsible for various aspects of one's life, including health and well being. Practiced medicine in the Yoruba tradition is known as oogun, with healing known as iwosan, and traditionally encompasses the use of combining herbs with incantations and/or sacrifice to the orisha thought to be responsible for the illness or disease or the orisha that can serve as a catalyst for healing (Oyaronke Olajubu).
According to Yoruba doctrine and belief, healing is viewed as a means of restoration and is strongly influenced by ones perception of their disease and its potential outcome (Sawandi). In modern medicine, this is called self-efficacy. Among the Yoruba, sickness attests to the fact that one experiences illness because they are not in tune with nature and the supernatural which are represented by the various orishas or deities, thus the physical signs of illness are just a part of an underlying condition or situation potentially affecting ones entire life (Oyaronke Olajubu).
Herbal medicine is an African tradition. There are closely guarded secrets of healing and wellness from Yoruba priests, priestesses and healers that cover over 10,000 years of knowledge in the West African Yoruba tradition (Sawandi). By ritual, Yoruba practitioners would transmit their knowledge of herbal remedies and medicines orally from one generation to the next. This knowledge has travelled from continent to continent via the transatlantic slave trade to create a forum of healing and custom that is the foundation and basis of Yoruba healing principles and practices. For thousands of years, many people of the African continent had a faithful and confident dependence on the use of various plants of the earth for the alleviation and avoidance of certain chronic and acute illnesses (Lyn Schumaker). Like healers in many cultures of the world, Yoruba herbalists have drawn on a large body of knowledge in the course of over 10,000 years, and yet the world has ignored and overlooked the African contribution to medicine and the healing arts largely because advocates of Western medicinal practices seem to reject anything that could be viewed as "obscurantism" (Consentino). The unknown is historically feared and various aspects of healing and medicine with African origins are no different. However it is this vast body of knowledge that compels persons of African descent to seek these traditional treatments in response to illness and disease.
Traditional Choices and Standards of Care Based on Religious Practices - Christianity
The practice of Christianity is varied and distinct by groups, but however includes one basic tenet, and that is that Jesus sacrificed himself so that the sins of the world can be cured. Traditional choices and standards of care with a Christian focus typically do not involve visits by a practitioner with a religious or spiritual focus, but do embody a system of prayer to Jesus by either the person afflicted or collectively in a group. The lens of spiritual healing from a Christian perspective can be narrow in its focus when prescribed to heal and treat illness and disease (Brown)and has prayer as its major spiritual weapon of choice.
Although it took Western medicine a century to embrace this perspective, African based medicinal practitioners discovered early the connection between mind-body-soul and spirit (Anandarajah: Harley). The power of faith and prayer healing is effective because the practitioner simply believes that it works. Traditionally, persons of African descent would not knowingly choose medical treatments, diagnosis and alternatives with an African based religious focus; however these were practiced as part of their day-to-day living and existence. These include; dirt and cold as a basis for contracting illness, as well as improper diet and conduct that can be defined as morally offensive (Harley). Each of these is similar in belief to African folk healing traditions and methods, thus African based healing is inherent in persons of African based cultures.
Another African based ritual that is actively practiced by practitioners of the Christian religious faith is the use of copper to treat pain and joint disorders. Historically, slaves would tie a piece of copper around their ankle to assist in the treatment of joint pain. Over time this would become a copper penny and are currently bracelets made of copper that are specifically used for this purpose (Harley). African-Americans typically embody beliefs that over time have become a part of their cultural identity even with choices of medical care and treatment. Harley notes:
"Often among elderly African-American women is "kitchen talk", which is an informal gathering of friends around the kitchen table to eat and talk about whatever is on their hearts and minds" (Harley, 440) including issues of health and well being.
These meetings of the mind among the elderly served as places of healing not just to acquire new information and techniques, but to heal the mind and spirit.
Contemporary Medicine and Healing in Society Today - Yoruba
As stated prior, the Yoruba tradition embodies a series of gods or orishas that are responsible for various aspects of one's life. In rural areas, Yoruba priests and priestesses were the medical practitioners, not in the absence of Western based medical treatment facilities but by choice of the patient (Eades). Present modern practices of Yoruba healing and medicine seek to encourage the use of herbs for healing and to incorporate the use of Western medical techniques instead of sacrifice and/or incantations (Oyaronke Olajubu), however this new method of practice is still contestable among the Yoruba tha t seek to remain true to its practice via the traditional method. The Yoruba healer should be someone familiar with the patients' worldview and belief system, as well as have extensive knowledge of herbs and various medicinal practices. Yoruba healers are also expected to be on good terms with various orishas to affect the healing process for a positive outcome (Cuthrell-Curry:Oyaronke Olajubu).
In the absence of a medical cure for HIV and AIDS, infected African-Americans may seek alternative treatments that are consistent with cultural and social beliefs (Suarez) to include African based medicinal practices. In a study conducted by Suarez in 1999, 73 percent of HIV infected African-American individuals believed in good and evil spirits that played a role in their HIV status; of these, two-thirds engaged in the practice of folk healing and/or traditional medicine with African origins, particularly Yoruba (Suarez, 685). Thus medical choices by some African-Americans with a spiritual or religious focus are potentially important aspects of their medical choice of care.
The most common aspects of Yoruba medicinal and healing practices in use today by African-Americans afflicted with chronic illnesses seem to be; lighting candles, saying spiritualist prayers, blessed oils, and special herbal bath additives (Consentino) used in conjunction with medical treatments from contemporary medical practitioners. These remedies for a cure or relief are used in combination with visits from a Yoruba priest or priestess that perform rituals to assist in the healing journey (Cuthrell-Curry). Currently, a visit by Yoruba priest or priestess involves a "prescription" for healing where the healer observes the patient in an effort to "prescribe" various treatments for success (Oyaronke Olajubu). This process is also not performed alone as the Yoruba practitioner may consult from their colleagues and their vast body of information.
A key difference is the role women play in the Yoruba healing and medicinal process. Yoruba medicine women are a staple in this belief system and feature prominently in its sphere (Oyaronke Olajubu). Medicine women in the Yoruba tradition are known as onisegun and training for this special area begins when a girl is still very young, possibly in her early teens, unlike Western medical knowledge that does not begin until one is typically 25 (Eades).
Contemporary Medicine and Healing in Society Today - Christianity
Many African-Americans that embrace a Christian religious perspective actively practice medical and healing techniques with roots in African culture (Lyn Schumaker: Harley). A key reason for this is the cost effectiveness of treatment (Harley). Historically, Africans of the Diaspora were forced to locate medical care that did not involve Western based medicine, and this was usually their best choice. African-American healing traditions which are sill thriving today are deeply embedded in the regional history of the American South and have a primal place in the African Diaspora. Harley states:
â€¦..healing practices with African roots have been a hallmark of wellness for the African-American community as well part of the response to lifes challenges and changes. Indigenous healing practices regardless of their geographical location have their origins in African folk medicine and practices (Harley, 436).
Examples of African based medicine in current remedies are; garlic for reducing high blood pressure and high cholesterol, molasses or honey for curing a sore throat, and a penny tied to the ankle to releive arthritis and/or rhuematism (Harley). African-Americans have over time developed a particular set of beliefs and a world view rooted in religion and spirituality that will influence everything in thier lives, including medical choice.
When harvesting slaves, traders unknowingly brought togethr many traditional healing and belief systems together. These Africans, upheaved from their own medicinal culture and tradition, forged a new system of healing and ritual in an effort to not only survive slavery, but its long journey across the middle passage.
In contrast, practicers of Yoruba or other non-traditonal African-American religions may not seek medical care that utilizes Western medical techniques unless a chronic or incurable illness such as cancer, or HIV/AIDS is diagnosed (Suarez), and then, only in the end stages if African based healing techniques have failed. A key reason for this difference is the past experimentation on African-Americans using Western medical techniques. One such catastrophe is the well-known Tuskegee Syphilis Trials. For forty years between 1932 and 1972, the U.S. Public Health Service (PHS) conducted an experiment on 399 black men in the late stages of syphilis. These men, for the most part illiterate sharecroppers from one of the poorest counties in Alabama, were never told what disease they were suffering from or of its seriousness. Informed that they were being treated for "bad blood," their doctors had no intention of curing them of syphilis at all and were only interested in their corpses for observation and experimentation when they died (Brunner). Fear of possible experimentation and maltreatment is a fear among many African-Americans and is a deterrent for use of Western medical techniques.
Africa Meets America - Blended Healing Traditions and Techniques
Blended healing techniques coupled with the search for health and wellness are compelling reasons for the conjoining of African based healing rituals with contemporary Western medicine to develop a better overall system of care. The current bio-psycho-social model for the treatment of illness and disease has become ineffective for a culture with roots based in healing techniques that involve a spiritual focus. Traditional as well as modern medicine are integral components of various healthcare delivery systems across the globe (M.M Tabi). In a society of scarce medical choice, diversity and constant transition and belief systems, approach to health care should be based on a personal understanding of one's beliefs, life and being. In short healthcare delivery should be pluralistic and involve a bio-psycho-social-spiritual method of delivery to encompass total care.
Modern and traditional health systems should operate with the common goal of protecting and preserving health, however the historical and standard of practice has been a mutual disregard each has for the other one (M.M Tabi). Although slow to the call, contemporary Western medicine is making a move in the right direction. Biomedical approaches have their benefits, however, among the African-American community; these approaches may not be well equipped to analyze the various dimensions of health and wellness in the African-American community on their own (Harley). According to Harley, many elderly African-American believe their illnesses are magical and may be outside the realm of western medical techniques (Harley, page 439), thus indigenous methods of healing and medicine, used collectively with Western medical techniques may offer better overall care for patients with strong belief systems in alternative medicine.
Medical Doctor or Shaman/Priestess - Cost Effectiveness of Medical Treatment
Cost effectiveness of treatment and care is a rational concern for African-Americans that need medical services, especially when per capita income for this culture is only an average of 28,000 well below the poverty line for a family of 4-5 (Encyclopedia of the Nations). Medical care and treatment with African origins offer cost effective methods of treatment because pharmacies, costly medical equipment and tests, high educational debt and drives to generate revenue by hospital administrators are usually not involved in their use (Lyn Schumaker). Many practitioners of African based medicine typically charge minimal amounts for their services and will accept barter agreements that included "service for service" agreements (Harley).
Religion and spiritual involvement are a very integral part of medical choice, particularly in the African-American community. This involvement crosses gender, class and age groups, as most African-Americans embrace a spiritual perspective when making medical choices. Healing and medicine with roots in African Culture have been found to be a part of that decision making process even when one chooses to embrace a Western perspective regarding health care and medical choice. A new medical model that incorporates the traditional inherent belief of the mind-body-spirit-soul connection and traditional medicinal techniques with African roots, offer a system of more blended format of care that incorporates all viable forms of medicinal healing, particularly those that incorporate African healing techniques and not dismiss then as "folklore". This perspective is not in its infancy, and travelled as part of the African Diaspora and continues to thrive today.