Traditional healers in Tanzania: sociocultural profile and three short portraits

Traditional healers are an important part of African societies, but unfortunately the knowledge of the extent and character of traditional healing and the people involved in the practice is limited and impressionistic. They are frequently ignored in studies of user/provider patterns, although they cover the health needs of a substantial proportion of the population. For future health planning it is necessary to know what the reasons are that even in big cities, where western health care services are available, traditional healers flourish, and even compete with each other for certain aspects. The aim of this study was to investigate certain aspects of the profession of traditional healing in general in different areas in Tanzania in order to get an idea about the kind of traditional medical services which are available, and about the people who provide such services. For this reason traditional healers were interviewed with a semi-structured questionnaire in different rural and urban places: in the Kilombero valley (Kilombero/Ulanga District), on the main island of Ukerewe (Ukerewe District), in the region near Bukoba town (Bukoba District), and in the settlement of Dar es Salaam (largest city of Tanzania). The results of the study show that traditional healers are a very heterogeneous group of persons not having much in common relating to their religion, sex and level of education. The traditional practice is very often taken over from a family member, but also other reasons for becoming a healer, like initiation through ancestor spirits, are very frequently given. More than 50% of the respondents practice full time. These full time practitioners are mainly found among men and in the younger age group. Treatment of in-patients, who can stay in special patient-houses, is offered by half of the traditional healers. Divination used as a diagnostic tool was found mainly among men, Referral of patients to the hospital was mentioned by almost all respondents in cases where they failed with the own treatment or when they knew that the patient would be better treated in the hospital or dispensary. While traditional healers are an important part of African societies, not enough is known about the extent and character of traditional healing and the people involved in the practice. The authors interviewed 23 male and 8 female traditional healers in the Kilombero Valley, on the main island of Ukerewe, in the region near Bukoba town, and in the settlement of Dar es Salaam to gain insight into what kind of traditional medical services are available and the people who provide such services. The healers are a very heterogenous group of persons without much in common with regard to their religion, sex, and educational level. The traditional practice is often taken over from a family member. Other reasons for becoming a healer, such as initiation by ancestral spirits, were also frequently given. More than 50% of the respondents practice full time; these healers are mainly male and younger. Inpatient treatment is offered by half of the healers, and divination was used in diagnosis mainly by male practitioners. Almost all healers reported referring patients to hospitals when traditional treatment failed to work or when they knew that the patient would be better treated at a hospital or dispensary.