spirit and healing in africa - University of the Free State

the study of African healing started to develop (Feierman & Janzen 1992:2). Anthropologists and
historians began to see that it was no longer tenable to regard African therapeutics as isolated,
and somewhat static systems, that existed along ethnological lines. They discovered that people
interpret their own illnesses in various ways, and that illness causations and health etiologies
were not necessarily constructed within and restricted to the ethnic boundaries which cultural
anthropologists had consistently adhered to. There was need for a reframing of health research,
because African healing practices were heterogeneous, dynamic and fused rather than neatly
matching ethnic groups and territories.
One of the implications of this paradigm shift (that became particularly clear within the field of
medical anthropology, a subdiscipline of cultural and social anthropology) is the shift of focus
towards the patient. The main issues now center on the patient’s own interpretations of health
and illness in the light of therapeutic diversity. So questions are reformulated in order to explore
people’s health-seeking behavior. For example, how does the patient interpret his or her illness?
What meaning does he or she ascribe to life and death, and to the causes of misfortune? How
does the patient create a coherent conception of health amidst the many therapeutic options?
Does the patient’s health-seeking behavior reflect a perspective of health that in its essence is
rooted in a particular, but shared, view on reality? Or is the patient’s health-seeking behavior
basically pragmatic in nature, and based on the accessibility and effectiveness of a specific
therapy? These questions have been answered in different ways, because they probe into the
complex and constantly changing patterns of how people make choices about improving their
health situation.
1.3.6 Fabric of health: making sense of health
The focus on the patient means retrieving a more dynamic dimension of health. “Much of what is
important about African healing becomes clear only when healers and patients and their relatives
are pictured actively creating the particular healing gesture, reshaping healing institutions, and
finding the meaning of misfortune” (Feierman & Janzen 1992:12). Health and healing only come
into being and become meaningful when the patient and his or her environment have found ways
to make sense of the illness, have explored the possible cause of the illness, and have surveyed
the therapeutic courses of action. The patient (usually together with relatives) is involved in a
dynamic process of responding to challenges and opportunities, in which the patient is testing
and negotiating his or her way amidst the plurality of health-repairing, or health-protecting
options. But the patients and the relatives are not the only ones who search and act upon the
challenges and opportunities that come to the surface in moments of dysfunctional health. The
healers, or healthcare providers, are also active contributors in the quest for healing, in the sense
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