For many people, familiarity breeds trust. Hospitals and clinics can be places of mistrust or uncertainty, in part because they are outside of people’s daily lives. Instead, people around the world can put more faith in prayer, worship, and other forms of religious practice and healing when faced with physical or mental distress.
anthropologists have long argued that biomedicine lacks confidence due to its focus on repairing bodies rather than treating whole people. This is partly because in many cultures health is seen as a state of balance. Fixing a part of the body does not necessarily restore balance as perceived by the patient.
It is not uncommon for people to believe that the cause of their illnesses is the result of curses or punishments from a deity or witchcraft.
People may also prefer care from nonmedical providers who are part of their culture, speak their language, and understand the social issues related to their illnesses. Thus, many people trusting socially or spiritually related remediessuch as traditional herbs, incantation, prayers or riddle.
Some South Africans have rejected biomedicine because of historical assaults on clinics and distrust of clinical care. This includes discrimination under apartheid as well as persistent systemic failures, such as long waiting times, drug stock-outs, inadequate equipment and poor doctor-patient relationship.
But little is known about what happens to people’s long-term health once they give up biomedicine. We wanted to know more about how people cope with chronic disease.
We interviewed 88 people recruited from a large disease surveillance network study in Soweto, South Africa. Anyone who participated in the larger surveillance study was invited to participate in qualitative interviews. Forty-eight of the people we interviewed had been diagnosed with a chronic illness; the others had never been diagnosed with a chronic disease. People with chronic conditions revealed that they did not rigidly adhere to a system of care, but moved between church healing, spirituality or biomedicine.
Social and spiritual factors influenced the choices participants in this study made to achieve health or healing. Recognizing the central role of prayer and spirituality in healing is crucial for clinicians and healthcare providers to understand why treatment focused on self-care and physical repair may not be effective.
God, church water and spirituality
God was central to participants’ conceptualization of health, illness, or death. There was a common belief that God was a supernatural being who determined what happened to people’s lives. Individuals were unable to attest to visible signs of healing through prayer, faith or spirituality. But they still trusted and had faith that they were or would be healed:
I tell myself that I was not born with hypertension, I was not born with diabetes. I know God will heal me.
Almost half of the participants believed that illnesses were linked to cultural or spiritual causes – such as evil spirits, curses, bad luck or bewitchment – and that only spiritual interventions and prayers could heal a person.
As a result, people mentioned that they had developed faith and a close relationship with God – through prayer and Bible reading individually or communally, and drinking church water for healing and healing. well-being.
For example, drinking church water or what some called “holy water” or “tea”, locally called “indayelo”, has emerged strongly as a way to achieve healing in Soweto. Church water has been described as a liquid mixture of water, oil, tea and some herbs, prayed by a church minister, pastor or “omama bomthandazo(“mothers/women of prayer”). This was served at church or prepared for attendees to take home. This was a common practice among members of the Zion Christian Church.
Church water was said to be helpful in calming the body or inducing vomiting. This process of “ukukhipha inyongowhich means “to excrete bile or bile”, was associated with the elimination of disease in the body.
In addition to trusting God and drinking church water, some of the study participants faced practices such as spending time alone and meditating.
Our results confirmed that distrust of hospital care in Soweto prompted some people to seek alternative care. An elderly man who manages diabetes and hypertension said:
I went to the clinic this month and the pills were out, the metformin diabetes pills weren’t there. I decided to use traditional medicine and church water.
Other participants revealed that they had stopped taking medication in the hospital because they trusted the church to heal them.
Thinking about how and where people recover is a fundamental goal of the health system. Yet, since so many self-perceived healings occur outside of the hospital and clinic, state programs must recognize that the overuse of metrics and outcomes to mark the nation’s health or disease neglects how people feel heard, heal and live well. Recognizing the many ways people live with multiple conditions is also crucial for looking beyond clinical settings and recognizing how and why people depend on family members, neighbors, or institutions such as the church to live well. and stay healthy.
Sociocultural nuances and biomedicine
Our study sheds light on the role of socio-spiritual factors in people’s understanding of illness and health, and how they influence the choices people make to achieve health or recovery.
Recognizing the role of socio-cultural nuances – from prayer to ritual – can not only improve the mental health of people with chronic conditions, but can actually improve physical outcomes as well. For example, a study among cancer patients found that patients who reported greater overall religiosity and spirituality had better physical health, greater ability to perform usual tasks, and fewer physical symptoms of cancer and treatment. Spirituality has also been important in helping patients retain their social roles and relationships in the face of illness.
Thus, the integration of socio-cultural nuances within biomedicine could offer patients more comprehensive care, combining biological, psychological, social and spiritual approaches.