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Traditional Healing in Niger, West Africa

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  2. 2. •Population: 14 million •UNDP Development Index: In 2006 Niger was ranked 177 out of 177 countries •Environment: •Sahel: Semi-desert region with unpredictable seasonal rains •In 2005, the population faced a severe food crisis following a 12 percent decline in agricultural production due to the 2004 drought. •Vital Statistics: •infant mortality rate of 81 per 1,000 live births • life expectancy of 49 years •literacy rate of 28.7 percent •gross primary school enrollment of 54 percent •Economy: Rain-red agriculture •46.7 percent of GDP in 2005 •livestock production accounts for about a third of the value added in the sector •average per capita income $280 COUNTRY PROFILE
  3. 3. •The health system performance is poor: •limited and unequally distributed human resources •structural adjustment impeding recruitment •population/health facilities ratios varying between 8950 and 30 680 •dysfunctional referral and counter referral systems • only one third of the population has access to health services, with the vast majority relying on traditional medicine •Development aid is focused on investments. Overall, it accounts for more than half the total annual Government expenditure in health, with the Government covering basic operating expenses PUBLIC HEALTH INFRASTRUCTURE
  4. 4. •Health system highly dependent on external funding • National priorities not taken into account by some partners • Weaknesses in current coordination mechanisms • Weak capacity for aid absorption. PUBLIC HEALTH INFRASTRUCTURE
  5. 5. The health system is mainly funded through external resources •Between 1994 and 2004, the Government allocated an average 6% of its budget to the health sector while foreign aid accounted for 27.48% of overall health expenditure (around US$ 26 million, i.e. 71% of Government health In terms of expenditure per inhabitant, investments remain low at US$ 7.82 in 2004. •Several bottlenecks impede community participation: •insufficient information and training, poor management •transparency and lack of care and provision to the poorest segments of the population. •Mutual health organizations are only beginning to develop and private health insurance schemes cover less than 1% of the population. PUBLIC HEALTH INFRASTRUCTURE
  6. 6. •In Niger, candidates for the license to practice traditional medicine are assigned to the National Hospital in Niamey, where they practice under the supervision of the Chief Physician • Once satisfied with the skills of the traditional medicine practitioner, the Chief Physician then recommends that the Ministry of Public Health and Social Affairs issue a license. LICENSING TRADITIONAL MEDICINE
  7. 7. 1. Hausa 53% 2. Djerma (Zarma) 21% 3. Fulani 7% 4. Tuareg 11% 5. Beri Beri (Kanuri) 6% 6. Arab, Toubou, Gourmantche 2% ETHNIC GROUPS
  8. 8. “Among the Tuareg people in the Air Mountain region of Niger, women are sometimes possessed by spirits called ‘the people of solitude’. The evening curing rituals of the possessed, featuring drumming and song, take place before an audience of young men and women, who joke and flirt as the ritual unfolds.” •Nomadic Group •“White” & “Black” Toureg peoples •Slavery, caste-system, or misconception? •Often missed by government and non-government health & education programs •Leads to sporadic bouts of violence and protest in the North •One of the reasons for Niger’s recent governmental decentralization TOUREG RITUAL
  9. 9. “Some of the essays in Modernity and Its Malcontents address familiar anthropological issues—like witchcraft, myth, and the politics of reproduction—but treat them in fresh ways, situating them amidst the polyphonies of contemporary Africa. Others explore distinctly nontraditional subjects—among them the Nigerian popular press and soul-eating in Niger—in such a way as to confront the conceptual limits of Western social science. Together they demonstrate how ritual may be powerfully mobilized in the making of history, present, and future. .” •Sedentary Group •Ethnic Majority •Located in Eastern Niger •Zinder was the capital of the ancient Damagaram empire, the country moved the capital to the Western Zarma city of Niamey due to water shortage •This move is cause for significant Zarma-Hausa tension HAUSA RITUAL
  10. 10. “While Rain Dances are persistent rites in the ecologically fragile environment of the Sahel, their success depends upon the absence of dissension within and among the World of the Spirits and the Social World. This linkage is dramatically exposed during the efforts to end the terrible drought of 1984. As intrusive values and changed social conditions alter the ancient relationship between the community and the ancestors, Songhay attribute such catastrophes to the failure to honor that relationship.” •Sedentary Group •The Zarma people are descendents of the historically powerful Songhay Empire (having traveled East from Mali) •The French chosen “Bouguoise” under-class •Located in Western Niger ZARMA RITUAL
  11. 11. “The Zarma designation of malaria is Heemar-ize. Heemar-ize means product or child of the harvest period or rainy season, during which people fell ill with malaria.” MALARIA
  12. 12. MALARIA
  13. 13. “Weyno is inherent in the person, congenital. As one tradipractitioner stated, ‘everyone has weyno’. Weyno is said to originate in the lower stomach. When provoked, due to for instance a change in food habits, weyno ‘rises’ and causes the person trouble such as loss of appetite, fatigue and headaches. Consequently, as one interviewee pointed out, one is never cured of weyno, it is only ‘calmed’, ‘the illness lies down’.” WEYNO
  14. 14. Tootosi: Zarma for Bilharzia • The designation of bilharzia as tootosi is recent. In the past tootosi designated primarily urinary problems, pain and urinating blood, seen as a manifestation of weyno BILHARZIA
  15. 15. Street Vendors •One of the most common sources of medication •Unregulated •Sold on the street and in markets by petty traders •Often the cause of death and morbidity •Many drugs fabricated in Nigeria •In Nigeria and neighboring countries the traffic of imitation drugs and medicine sold beyond their expiry date accounts for as much as 70% of the market •Unregulated •Directions in English (unreadable even to fluent English speakers) •Old ‘PHARMACIE PAR TERRE’
  16. 16. “The Zima is the priest of the cult of the holey, a spirit possession cult that lies at the heart of Songhay-Zarma religion. In his seminal work on Songhay religion and magic Rouch describes the cult of the holey as the most important manifestation of Songhay religion. The spirit possession cult with its public rituals and wide geographical reach has replaced older private and localised ancestor worship cults. External influences, such as neighboring cults and Islam, have been incorporated into the cult of the holey. The spirits (the holey) control the forces of nature and are the masters of the human world.” ZIMA
  17. 17. “The Marabout can have many different religious, social and therapeutic functions. Wall, in his study of health and illness among the Hausa in Nigeria, points to the multiple functions of the marabout as a counsellor, diviner, astrologer, fortune-teller, spiritual adviser, pharmacist and physician. The marabout, through his ability to read the Koran, has access to the realm of Islamic thought and to its secrets and spiritual power. Rouch points to the perception in Songhay-Zarma country of marabouts as learned men with magical powers . The marabout is consulted in quite diverse matters and he is called upon in all human activities, such as illness, harvest, war, glory, travel and wealth.” MARABOUT
  18. 18. GRIS GRIS
  19. 19. GRIS GRIS
  20. 20. GRIS GRIS
  21. 21. GRIS GRIS
  22. 22. WANZAM
  23. 23. “The ‘target groups’ interviewed included married women and men, elders, youths, local chiefs, ambulant medicine vendors, vendors of plants and local remedies, nurses at the local dispensary, nuns at the confessional dispensary, marabouts (Islamic priests and scholars) and zimas (the priests of the spirit possession cult). Direct observation was done in the local public dispensary, in the confessional dispensary, during a spirit possession ceremony as well as with ambulant medicine vendors. ” •Like the vendors of pharmaceuticals, ambulant vendors of medicinal plants come to Saga to sell. Some wheel a small cart full of plants and others carry baskets. They sell bunches of dried leaves, roots and bark from medicinal plants. The prices vary from 25 CFA to 100 CFA per bunch. The vendors are not herbalists as they do not diagnose and treat illnesses, they merely sell medicinal plants and indicate how they should be used. LAHIYA VITESSE AND THE QUEST FOR RELIEF
  24. 24. •Some of the traditional healers are specialists in one particular therapeutic area. For instance, the bone setter heals fractures and the blacksmith (forgerons) heals burns. The wanzam or barber is a kind of traditional surgeon who in addition to shaving and cutting hair also performs specialized surgery, such as circumcision, bloodletting and ritual and therapeutic scarifications •The yenaandi is held in each village at the end of the hot-dry season in order to ensure a good rainfall and a bountiful harvest. Occasional ceremonies are held for individual members of the spirit possession troupe, for instance in the case of illness or death. LAHIYA VITESSE AND THE QUEST FOR RELIEF