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Indigenous health psychology in Zululand PDF Print E-mail

The following article is an excerpt from Dr. Steve Edwards book "Health promotion: community psychology and indigenous healing" and offers some interesting insights into the Zulu mentality. Their everyday language that is presented in this article gives a very strong impression about how present the awareness of interconnectedness is lived amongst the Zulu people. Many thanks for the permission to reprint this article to Dr. Steve Edwards!

 

Indigenous health psychology in Zululand 

This is a chapter from a book by Edwards, S.D. (2002) Health promotion: community psychology and indigenous healing KwaDlangezwa: Zululand University. ISBN  1-86818-109-X  (pp.50-55)


The psychology of healthy relationships 

Like all forms of psychology, health psychology is concerned with the study of human relationships, especially as revealed in everyday meeting and lived dialogue. In response to the question: "Kunjane," how are you, a Zulu comparison may answer in various ways: 

  • sihambanakho implies we going/living with it, e.g. as part of life's everyday survival struggle. Another similar response would be sikhona-nje.
  • sikhona implies we are existing and present.
  • siyaphila implies we are alive, healthy and well.
 

If one was very healthy and in excellent condition one might reply siyaphila kakhulu. If we experience being sound, complete and whole, we might respond - siphilile. 
 
These responses reflect certain fundamental interrelated aspects of indigenous health psychology which may be explicated as follows: 

  • The collective psyche. This is revealed through the plural prefix - si(ya). Being healthy and alive is a collective and communal rather than individual matter as conveyed in the idiom umuntu umuntu ngabantu, which means a human is a person through others, only through you do I become an I, I am because we are. Being alive and healthy (impilo is used for both concepts) implies healthy relationships with the source of being i.e. God (uNkulunkulu/Mvelinqgangi) and ancestors (amadlozi), with other people (abantu) and the natural environment/world (endaweni umhlaba). Health is thus a collective responsibility to harmonize such relationships by finding the right tune or path (indlela). (Dube 1989, Oosthuizen et al., 1989) towards the ideal of beneficial humane relationships filled with dignity and respect (ubuntu).

 

  • Communal spirituality. Responses such as sikhona and siyaphila imply that our extended family and community of ancestors both living and dead are present and well. Traditional views on survival, life and health are inextricably related in the emphasis on ensuring proper relationships with the body of ancestors and God. People work at this relationship through scientifical, ceremonial and ritual gatherings to prevent illness and promote health. Such gatherings become communal spiritual labours of love as conveyed by the term umsebenzi where ancestors are appropriately remembered in the provision of spiritual protection and social support for the collective. A great variety of ceremonies to mark special occasions have been extensively discussed (Ngubane 1977, Gumede 1990). From an African Indigenous Church perspective, the emphasis is on responsibility for management of the Holy Spirit (umoya).

 

  • A balanced environment. Ngubane (1977) and Gumede (1990) have also extensively described how traditional Zulu cosmology is permeated with beliefs and practices related to ecological influences on community health. Families and communities have a ongoing responsibility to strengthen (iqinisa) themselves against such ecological hazards as lightning (ukubethela ceremony) and various forms of social conflict, jealousy and sorcery (ubuthakathi) traditional healers, diviners (izangoma), doctors (izinyanga) and faith healers (abathandazi) are extensively consulted in order to balance and order the environment (ukulungisa endaweni). The vast majority of community health psychology in South Africa is in fact provided by these indigenous health practitioners  (Edwards 1999).

 

 The psychology of illness prevention and health promotion 

Indigenous Zulu psychology of illness and health is a holistic cosmological matter characterized by forces of creation, especially ancestors (amadlozi) and destruction (ubuthakathi) (Berglund 1976, Gumede 1990).  However distinctions are made between those illness which are relatively more natural (umkuhlane) and cultural (ukufa kwabantu) in origin respectively (Ngubane 1977).  This is similar to the natural: supernatural distinction made  when considering lay theories of illness in an international perspective (Edwards et al., 1983).  

Umkuhlane refers to illnesses that just happen such as a fever or senile dementia. While the role of psycho-socio-cultural and religious factors are recognized in such illnesses, these latter factors are especially prominent in the ukufa kavabantu forms, where three main forms may be distinguished.  

Spiritual relationships with the ancestors and/or other spirits. For example some illnesses are believed to be caused by ancestral displeasure (abaphansi basifulathele). This may have been because certain rituals were forgotten or customs neglected (ukulahla amasiko). What is required in such cases to perform an appropriate ceremony (umsebenzi) in order to re-establish balanced relationships with the ancestors. Alternatively an individual may receive a call by the ancestors to become a diviner (isangoma) which is followed by a creative illness or religious conversions phenomenon that occur in many religious systems (ukuthwasa). This spiritual/cultural rebirth experience does not necessarily preclude the diviner belonging to another religion, such as an African Indigenous Church (AIC) or Western-style Christian church.  However this creative illness needs treatment either to bar the spirit (ukuvala idlozi) or to allow the neophyte (ithwasa) to undergo training to become a diviner under a qualified divine healer (isangoma). A third type of illness with regard to spiritual relationships occurs through alien spirit possession through the spirit of a person who has died away from home and for whom no ceremony was performed to integrate this persons spirit with the body of family ancestral spirits. The ceremony is referred to as ukubuyisa Indiki and amandawe are examples of such alien spirit possession. In this case treatment with both ancestral ceremony and treatment by a healer who had experienced similar alien spirit possession is needed (Ngubane 1977, Gumede 1990) to restore psycho social and community equilibrium and promote health.  

Human relationships. Ubuthakathi refers to all forms of destruction, especially those of malicious human beings, witches and sorcerers who are believed to employ magic, familiars and noxious substances to harm their victims. Such disordered relations are recognized as occurring in situations characterized by jealousy, rivalry, conflict, aggression and violence. Freud has similarly recognized human destructiveness as basic cause of illness with the concept of thanatos. Common types of illness attributed to sorcery are as follows: 

  • Ufufunyane was originally attributed to the use of grave dirt but today is more often associated with auditory hallucinations and culture contact stresses where the ill person is disturbed through hearing voices of persons of different racial and ethnic groups (Edwards 1999).

 

  • umeqo typically refers to hemipharesis or conversion disorder believed to be contracted through stepping over the harmful concoction of a sorcerer (Edwards et al., 1983).

 

These and other theories have been extensively discussed (Berglund 1976, Ngubane 1977, Edwards 1985, Gumede 1990). Treatment by traditional healers and/or modern therapist essentially consists in re-establish spiritual, human and environmental relationships, performing appropriate rituals to both protect and strengthen the vulnerable individual family and community and promote their future health, well being and fortune. In traditional diagnosis, diviners (izanforna) will work through their accepted mediumship with the ancestral shades and close relationship with the ill (vumisa) to identify the illness, its cause and required treatment. Doctors (izinyanga) use a wide variety of treatment including massage, steam baths and poultices as well as herbal medicines used in a ritual and symbolic context Faith healers (ubathandazi) mainly use prayer, holy water, baths, enemas and steaming (Oosthuizen et al. 1989, Edwards1999). 

Environmental relationships 

As indicated before ordering and harmonizing environmental relationships to viewed as critical for preventing illness and promoting health. Specific example of disordered environmental relationships include: 

  • umkhondo omubi a dangerous track or ecological health hazard such as lightning. Various practices such as covering water and mirrors during a thunderstorm and planting lighting conducting rods rather than trees near the home were followed to prevent being struck. In addition ukubethela ceremonies were performed by heaven herds (izinyana zezulu) to protect the home and promote health (Berglund 1977, Gumede 1990).

 

  • umnyama which refers to darkness, contageon or pollution associated with stresses of major life and death events e.g. birth, death, menstruation, sexual intercourse and fatal accidents.  Health is promoted and illnesses prevented if moderation and abstinence is practised during a bereavement. In this way stress is minimized and social support enhanced. People who do not respect such taboos (ukudlula) stand much greater chance of illness, trauma and crises.

 

Wholeness and life 

The holistic nature of preventive and promotive practices cannot be overemphasized. Spiritual, human and environmental relationships form aspects of indigenous Zulu cosmology. It is believed that people are most vulnerable when in new environment, exposed to different climatic conditions, situations of conflict and strife and neglect of important ancestral ceremonies. On the other hand if appropriate rituals are performed to ensure ancestral care (abaphansi banathe) and promotive treatment is taken (umuthu wokuquinisa) to prevent sorcery and environmental hazards, harmony and balance result.    

Health is highly prized. Ceremonies are gratefully performed to give thanks (ukubonga). These gatherings constitute a marvelous form of community health psychology. Animals killed for the occasion provide much needed protein.  

When a person is ill traditional doctors attending are not paid. Only a small fee is given (ugxa) for the doctor to open his bag. He only expects to be paid when health is restored to his clients, who  are often taken in to his home for an extended period (Gumede 1990). Such beliefs and practices are found throughout Africa where indigenous healers, sanctioned by the community as accepted medium with the cosmos especially in terms of spiritual, human and environmental relationships (which Myers, 1993 has referred to as ntuological, rather than technological). I visited a traditional healer in Uganda, who cared for over a hundred clients in a traditional hospital. All clients had relatives staying with them in the hospital. Over time, the patients had built different hospital rooms with various purposes, e.g. divination, demon exorcizing, massage, purifying steam baths. All clients were treated free of charge. They would pay the healer in some form according to their conscience after coming healthy. Without any formal professional qualification, the healer was a community health psychologist gifted by his spiritual calling, community recognition and therapeutic effectiveness in facilitation of the community of patients in healing themselves.  

Conclusion 

Ngubane (1977), Oostuizen et al (1989) and Myers (1993) have described Africans as always in search of life enhancement in terms of an increase in being and wholeness, with wholeness is viewed as a dynamic concept in that there is no fixed point of perfect health.  In the words of Dube (1989:134), "the whole concept of wholeness reflects a new attitude to life. Life is seen as a sliding scale with death on the one end and increase in life on the other end. Good healthy good fortune and therefore wholeness point to an individual's or a society's movement on the life scale."   

Everyday indigenous health psychology in Zululand is aimed at the promotion of harmonious humane relationships characterized by dignity and respect (ubuntu). This means work (umsebenzi) at maintaining the balance (hlehlo) and renewing and creating new forms of harmony especially with regard to God and ancestors, Christ and Holy Spirit and safe environment beneficial to community existence, survival and health.

References

 

Berglund, A.I. (1976).  Zulu thought patterns and symbolism.  Cape Town: David Phillips. 

Dube, D. (1989).  The search for abundant life.  In Oosthuizen, G.C., Edwards, S.D., Wessels, W.H.and Hexam, I. (Eds).  Afro-Christian religion and healing in Southern Africa.  Lewiston: Edwin Mellin.  

Edwards, S.D., Grobbelaar, P.W., Nene,L.M., .Makunga, N.V., Kunene, S.T. and Sibaya, P.T. (1983).  Traditional Zulu theories of illness in psychiatric patients.   Journal of Social Psychology, 121, 213-221. 

Edwards, S.D. (1985).  Some indigenous Zulu views on illness and healing.  Series B, No. 49.  KwaDlangezwa: University of Zululand. 

Edwards, S.D. (1999).  Community psychology: a Zululand perspective.  KwaDlangezwa: University of Zululand. 

Edwards, S.D. , Cheetham, R.W.S., Majozi, E. and Mkhwanazi, I. (1985).  The treatment of umeqo with hypnotherapy and cultural counselling.  Psychotherapeia, 28, 24-29. 

Gumede, M.V. (1990).  Traditional healers: a medical doctor’s perspective.  Cape Town: Skotaville. 

Marks, D., Murray, M., Evans, B. and Willig, C. (2000).  Health psychology.  London: Sage. 

Myers, L. (1993).  Understanding an Afrocentric world view:  introduction to an optimal psychology.  Kendal Hunt: Dubuque. 

Ngubane, H. (1977).  Body and mind in Zulu medicine.   London:  Academic Press.  

Oosthuizen, G.C., Edwards, S.D., Wessels, W.H.and Hexam, I. (1989).  Afro-Christian religion and healing in Southern Africa.  Lewiston: Edwin Mellin.  

Strumpher, D.J.W.  (1990).  Salutogenesis: a new paradigm.  South African Journal of Psychology, 20, 265-276.