Ethical Issues In The Treatment Of Mental Illness By African Traditional Healers
It has often been cited that over 80% of people in Sub-Saharan Africa have at least once used traditional medicine (WHO, 2002:1). Traditional Healers (TH)are consulted for an array of things from physical,mental illness to social problems, etc. This study aimed at investigating Ethical issues in the treatment of mental illness by African traditional healers. This study is qualitative following phenomenological design. Non probability availability and snowball sampling was followed when selecting potential participants. Seven participants (4 males and 3 females were requested to participate in the study. An interview guide comprising 8 sections with closed and open-ended questions was used. Section 1: Sociodemographic information; Section 2: Training and certification of traditional healer; Section 3: Presenting symptoms of patient; Section 4: Diagnostic strategies used; Section 5: Causes of mental illness; Section 6: Medication; Section 7: Referral; Section 8: Confidentiality on the part of the traditional healer; Two participants who did not form part of the study was selected for pretesting. Individual face to face interviews were conducted in the household of patient, Tshivenda language was used to conduct the interviews. Issues of Trustworthiness – Credibility, Transferability, Confirmability were tested. Data was analysed using Interpretative Phenomenological Analysis. Ethical Issues were observed (Information sheet, verbal informed consent or written consent form). Participants comprised4 males, 3 females; Age ranged between 40 and 70; post matric qualification; White collar employment; Three belong to Christianity while four belong to African Religion. Different themes emerged and similar themes were grouped together. The following main themes emerged: Training and Certification of traditional Healers (They do not undergo formal training to become healers, but are mentored by an experienced healer who will also determine their competency. Symptoms presented by patient (Traditional healers also establish if there is comorbidity); Diagnosis (Traditional healers use a variety of diagnostic strategies including History taking; Physical examination; Bone throwing; dream interpretation); Causes of mental illness is attributed to Supernatural powers; witchcraft; Displeasure with ancestors; Medication, proper labelling, side effects are explained to patient, dosage is usually a problem because there is no scientific way of weighing dosage which can result in overdose; Referral of patients is rarely done to western medical practitioners, patients are mostly refered to other traditional healers; Confidentiality are rarely observed as it is uncommon for a patient to consult traditional healers alone. Patients are usually accompanied by their family members who will also be present in the consultation room. Data was obtained through self-report which is limited by the fact that it rarely can be independently verified. It means that as a researcher I had to take what people say at face value. TH will always play an important role in the lives of those who utilise their services and those who are affected by them.