Magical Empiricism and 'Exposed Being' in Medicine and Traditional Healing

"Sex is supposed to be naturally more pleasurable": Healers as providers of holistic sexual and reproductive healthcare in Uganda

Global health researchers often approach Traditional, Complementary, and Alternative Medicine (TCAM) from a health efficacy perspective, asking whether the presence of plural medical systems helps or hinders the uptake of biomedicine. Medical anthropologists, by contrast, typically emphasize how plural medical systems encourage us to rethink health ontologies-that is, who and what comes to constitute the experience of health and illness, and through which practices. Building on both approaches, we explore the role of "healers," a term we use to encompass several different kinds of TCAM providers, in the sexual and reproductive healthcare (SRH) of young people from southcentral Uganda, a region well known as an HIV/AIDS epicenter. Drawing from ethnographic data, we describe three reasons that young people seek SRH from healers. First, they associate stigma, scarcity, and high costs with biomedical SRH. Second, healers work across biomedical and non-biomedical therapeutic divides, prescribing herbs for sexually transmitted infections while simultaneously referring clients to biomedical HIV clinics. Third, healers provide counseling focused on pleasurable and economically-motivated sex. Because these therapies diverge from international and national HIV prevention messaging that frames non-marital and transactional sex in terms of danger and disease, healers' holistic approach to SRH may help to reconstitute the meaning, practice, and experience of "sexual health" in contemporary Uganda. This has important implications for improving global SRH programs and for understanding the continued appeal of TCAM more generally.

"Satanism is witchcraft's younger sibling": Changing perceptions of natural and supernatural anaemia causality in Malawian children

In countries of sub-Saharan Africa, many children are admitted to hospital with severe forms of anaemia. The late hospital admissions of anaemic children contribute significantly to child morbidity and mortality in these countries. This qualitative study explores local health beliefs and traditional treatment practices that may hinder timely seeking of hospital care for anaemic children. In January of 2019, nine focus group discussions were conducted with 90 participants in rural communities of Malawi. The participants represented four groups of caregivers; mothers, fathers, grandmothers and grandfathers of children under the age of five. The Malawian medical landscape is comprised of formal and informal therapeutic alternatives–and this myriad of modalities is likely to complicate the healthcare choices of caregivers. When dealing with child illness, many participants reported how they would follow a step-by-step, ‘multi-try’ therapeutic pathway where a combination of biomedical and traditional treatment options were sought at varying time points depending on the perceived cause and severity of symptoms. The participants linked anaemia to naturalistic (malaria, poor nutrition and the local illnesses kakozi and kapamba), societal (the local illness msempho) and supernatural or personalistic (witchcraft and Satanism) causes. Most participants agreed that anaemia due to malaria and poor nutrition should be treated at hospital. As for local illnesses, many grandparents suggested herbal treatment offered by traditional healers, while the majority of parents would opt for hospital care. However, participants across all age groups claimed that anaemia caused by witchcraft and Satanism could only be dealt with by traditional healers or prayer, respectively. The multiple theories of anaemia causality combined with extensive use of and trust in traditional and complementary medicine may explain the frequent delay in admittance of anaemic children to hospital.

Contextual influences on sentence repetition as a tool for the identification of language impairment in Grade 3 Sepedi-English bilinguals: A case against bilingual norms

BACKGROUND

Specific language impairment (SLI) is difficult to identify because it is a subtle linguistic difficulty, and there are a few measures available to differentiate between typical and atypical language development in bilinguals. Sentence repetition (SR) has strong theoretical foundations and research evidence as a valid tool for the identification of SLI in bilinguals.

OBJECTIVE

This study assessed the value of SR using peer group comparisons to identify Sepedi-English bilingual children at the risk of SLI.

METHOD

One hundred and two Grade 3 learners in three different contexts of education were assessed on equivalent English and Sepedi SR measures.

RESULTS

Eleven participants who scored between 1 and 2 standard deviations (SD) below the peer group means on both the English and Sepedi SR tests were identified with possible SLI. Learners in the English language of learning and teaching (LoLT) - Sepedi additional language (SAL) context obtained similar scores in both languages, a higher score in English than the English LoLT group and a higher score in Sepedi than the Sepedi LoLT - EAL group. The English LoLT group obtained a significantly higher score in English than in Sepedi and a significantly lower score than the other two groups in Sepedi. The Sepedi LoLT group obtained a significantly higher score in Sepedi than in English, their additional language, in which they obtained a significantly lower score than the other two groups.

CONCLUSION

Sentence repetition tasks are valid screening tools to identify bilingual children with SLI by comparing them to peer groups. The SR tests were sensitive to language practices in different educational contexts. It was observed that a bilingual approach that uses both English and the home language as academic languages leads to better language outcomes.