Background
Methods
Study design and setting
Study population and period
Sampling and recruitment of respondents
Data collection
Data management and analysis
Codes | Code definitions |
---|---|
Definition of cancer | Any references to what cancer is, or is not |
Help-seeking for self and family | Any references to where the healer and family members go for help-seeking whenever illness is perceived |
Medical pluralism | References to whether sick people should seek help from several sources including biomedicine and traditional health practices concurrently or sequentially, and whether such practices are considered good or harmful to the patients |
Causes of cancer | Any references to what leads to development of cancer or how cancers are perceived to come about in a person |
Symptoms of cancers | Any references to what are perceived as indicators or signs that a person with cancer develops |
Diagnosis of illness | References to how a healer or a person may detect a particular kind of illness including cancers, and give names or labels to the illness |
Treatments for cancers | Any references to concepts about the types of treatments or remedies that are considered to work on cancers, including why it is thought so |
Forms of healing | References to the different approaches and or things that THPs do to help patients regain health, and the types of healing practices in traditional medicine practice, including giving medicines, surgery, incantations, and administration of rituals |
Rituals used in treatment | All references about things that healers or elders do other than giving physical medicines, to help a person who is ill to get better or regain health |
Illnesses treated | References to the types of diseases or illnesses that a healer says he/she treats and how he/she decides which illnesses to treat or specialize in treating |
Becoming a traditional health practitioner | Any references to how one becomes or became a THP, including the processes of initiation and or source of inspiration to become a healer |
Power of healing | References to the ways in which one gets inspirations, desire to heal, and actually be able to help a sick person regain health |
Types of THPs | References to the different categories of healers based on types of services provided or how they treat illnesses and or how they became healers |
Duration of practice as THP | References to the period since when a THP gained healing power and started providing help to people to regain health |
Detection of potent medicines | References to how a THP gets to know which plants/materials work as medicines for particular ailments |
Awareness of good THPs | References about how members of the community get to know who a good THP is and therefore decide to seek help with him/her |
Occupation | Any references to what the THP used to do before becoming a healer or does concurrently with healing practices, including any formal qualifications |
Traditional surgical practices | Any references to practices that require cutting on a person perceived as ill, with the intention to relieve distress, pain or cause healing, including the title given to the person who does the cutting procedure |
Safety in surgery | Any references to the conduct of traditional surgical practices in a way that prevents dirt and infections from getting into the patient, including how to clean and sterilize the equipment used in the surgery |
Cancer early detection | Any references to whether there are stages that cancers develop through, what needs to be done in order to know that there is cancer when it is still in early stage, how early detection can be done, and the benefits for early detection |
Sources of ill health or diseases | Any references to what leads people to fall sick or how illnesses get into people and therefore make them become sick |
Challenges treating cancers | References to difficulties experienced in treating patients with cancers and reasons for such difficulties |
Cancer prevention | Any references to what should be done to reduce the chance of a person getting a cancer/cancers, and whether it is difficult or easy to prevent cancers |
Collaborations between HCP and THP | All concepts related to whether or not THPs and biomedical practitioners should work hand in hand with each other including referring patients to each other’s practices, and reasons for such referrals |
Meaningful collaborations | References to the conditions that need to be put in place, or things to be done so that THPs and biomedical practitioners can work together in harmony with mutual benefits in the prevention and management of cancers |
Hindrances to progress in THP practices | Perceptions and references to what makes the field of traditional health practice not develop, grow, flourish or be practiced in the open, including the difficulties that THPs experience |
Self-protection during THP practice | References to precautions undertaken by THPs to avoid getting infections from their patients |
Results
Respondents’ characteristics
Characteristics | Respondent’s code | Total |
---|---|---|
Sex | ||
Male | R2, R3, R4, R6, R7, R9, R10, R11, R12, R13, R14, R15, R16, R17, R18, R20 | 16 |
Female | R1, R5, R8, R19, R21 | 05 |
Age group (Years) | ||
30—39 | R1 | 01 |
40—49 | R8, R9, R10 | 03 |
50—59 | R2, R11, R12, R13, R14, R15 | 06 |
60—69 | R16, R17, R18, R19, R20, R21 | 06 |
70—79 | R3, R4, R5 | 03 |
≥ 80 | R6 | 01 |
Missing | R7 | 01 |
Median age: 59 | ||
Marital status | ||
Married | 21 | |
Educational attainment | ||
No formal education | R3, R7, R13 | 03 |
Primary education | R1, R4, R5, R6, R12, R14, R19, R21, | 08 |
Secondary education | R8, R11, R17 | 03 |
Advanced level education | R15 | 01 |
Tertiary/university | R9, R18 | 02 |
Vocational training | R10, R16, R20 | 03 |
Missing | R2 | 01 |
District of residence | ||
Agago | R3, R20 | 02 |
Amuru | R2, R5, R7 | 03 |
Gulu | R9, R10, R14 | 03 |
Kitgum | R11, R16, R19 | 03 |
Lamwo | R4, R6, R12 | 03 |
Omoro | R1, R21 | 02 |
Nwoya | R13, R17 | 02 |
Pader | R8, R15, R18 | 03 |
Understanding of ‘cancer’
New and challenging disease
“In the past we didn’t know them but there is a possibility that it has always been there. Culturally I don’t know of any explanations for cancer”, (R8, Male, 40-49 years).“You should know that cancer is a new disease in this part of the country and even traditional medicine practitioners can’t understand it. […]. And it comes in various forms, sometimes it catches the breasts, sometimes it comes with blood flow”, (R9, Male, 50-59 years).
Imbalance within the body
“I would say it is not a sickness but an imbalance within the body which causes conditions which come up like cancers; and some are reversible. Specifically let me talk about cancer, we have cancer cells in our bodies, but when time is favorable that is when they come up”, (R20, Male, 60-69 years).
Perceived causes of cancers
“The way cancer starts, what brings and how it starts showing in you is a mystery; but you only get to realize pain in your body, and that pain only comes when it has already existed in your body for quite long; it is only the medics in the hospital who can diagnose that it is cancer, no one should boast that they are the ones who diagnose it. I also remain in the same position. I also don’t know what brings cancer, and for me I started treating it after it had already come”, (R7, Male, Missing age).“But God has created people differently in this world; but at times people think it is because someone with ill intentions has bewitched them or they have been curse but that is not the case. We simply don’t know what causes cancer and how to cure it”, (R16, Male, 60 – 69 years).
Chemicals agents
“Actually the causes of most cancers are unexplainable even to the Doctors; however some are explainable. For example, if you have been working in a chemical factory for long you will have strange sicknesses which can’t even be diagnosed in the hospitals. At times you can ask the patients and they tell you that yes they have worked in a factory for long, so you just know that this thing has been caused by working in the factory. You see, so it doesn’t come in one day, it comes slowly, (R6, Male, 80+ years).
Metal deposition in the body
“The thing that brings cancer . . . Some people have been mentioning that use of steel wire; some people guessed that grinding mills for grinding flour. But I also thought deep and get to question that people have lived many years ago and I personally found grinding mills in existence, and right now I am old but still alive and strong; so if steel wire I may believe. When you scrub your saucepan neatly and you dry it, pick the saucepan and wipe the inside with your fingers; you will still find some dust from steel wire and this is how it enters into our bodies, mix with fluid and ends up causing cancer in our bodies. I can accept that cancer comes in that way”, (R7, Male, Missing age).
“Yes, breast cancer is like you who swallows food and takes water, then it tries to get out of the nipple but get stuck in the breast, because there is a sieve in the breast which will arrest it. It is the steel wire that I have been talking about. […] For the cervix, it is also the same; it will go and settle, once it settles, it has to bring wound and once it has come, it will increase further in size . . . this is my suggestion, (R7, Male, Missing age).
Poor diet
“I think cancer is caused by poor eating especially the foreign foods that we have today. Food that the Acoli are not used to is also causing cancer. I leave that to the doctors to investigate”, (R11, Male, 50 – 59 years).“One of the main causes of cancer today is the food we eat because we eat toxic foods . . . That means we have to come up with good food, with organic food . . . those organic foods can suppress those cancer cells. In Acoli, they don’t want you to eat fresh meat; you first smoke it or hang it somewhere so it drips first”, (R20, Male, 60 – 69 years).
Cancers are hereditary
“Cancers also run in certain families. I know of a family that has had almost three people who have had cancer. The latest is their sister who has breast cancer. So I think it runs in the family”, (R8, Female, 40 – 49 years).
Bad spirits
“Those are spirits (tipu). They are spirits that when treated well can heal. It is just that they are very few that come to the healers when they are sick”, (R18, Male, 60 – 69 years).
Cancers are sexually transmitted
“The root cause and main cause is some of the girls go for what they are not supposed to do, and they acquire it. It can be transmitted through sexual intercourse or sharing pit latrine or getting into contact with somebody who is already infected”, (R8, Female, 40 – 49 years).“So you know like women are open; when you go to a toilet, you can get things like candida or syphilis. Those can accumulate in you and become things like cervical cancer, you see”, (R8, Female, 40 – 49 years).
Treatment of cancers with traditional and complementary therapies
Adjunctive role of T&CMs in healing
“The benefit is really great . . . herbs don’t have side effects unlike the modern medicines. Our herbs can even be eaten as food unlike the modern drugs”, (R1, Female, 30 – 39 years).
“The way I understand most illnesses, when the healthcare professionals try in vain to treat it, they send you back home so you seek traditional remedies to it. If you are done with such traditional ways of treatment then when you go back, the modern medicines will work. […] When you first sort out the traditional issues, then the modern medicines will now work and you will live”, (R15, Male, 50 – 59 years).
No T&CMs cure cancers
“No, I did not. She was taking medicine that they gave her from the hospital so I couldn’t interrupt her treatment and beside I don’t have its medicine. And I have not dreamt about it, maybe one day when I dream then I will treat it”, (R5, Female, 70 – 79 years).“You should know that cancer is a new disease . . . That is why there is no one in the community who says they can give medicine for cancers, no one should try treating it. It is even defeating the white people, and they say that if it takes long it can’t heal completely . . . So, I think more research should be carried out in that field to try and come up with its cure. In the past elders would do anything to try and remedy certain illnesses but this is beyond us now. I simply can’t explain it. And my plea to you is as you continue moving don’t let anyone deceive you that they can treat cancer, it is a lie”, (R9, Male, 40 – 49 years).
“You see in this work of ours, one has to be honest to themselves and also to the patients. If I can’t explain the cause of a disease or I feel I am not the right person to handle it, then I refer them to someone else who can do it more than me. So when I see a rare illness that I have not seen before, I refer them to the hospital for tests, and I believe cancer falls in that category”, (R8, Female, 40 – 49 years).
Medicines for the treatment of illnesses with similar presentations can be used
“You know cancer wasn’t there in the past; it is a new phenomenon . . . For example, cervical cancer presents like syphilis; so to us herbalists, we put it in that category. We use medicines that is similar to the one we use to treat syphilis. You see, especially cervical cancer, it affects the opening of the womb and spreads to the lower belly. So if we give that medicine and she starts taking, all that will come out”, (R1, Female, 30 – 39 years).
T&CMs cure cancers
“So, with cancer cases we need to affect it from the very roots. That is what this medicine can do. I have treated very many cases of cancers; breast cancer, cervical cancer, colon cancer. This medicine you don’t only take it when you are sick, you can also take it to cleanse up. So you can keep, you can always take it when you need it” (R20, Male, 60 – 69 years).“Cancer treatment using traditional medicine is the best, especially if the patient is brought in its early stages. It does not have side effects like falling off of hair or nails”, (R21, Female, 60 – 69 years).
“I told them that this is cancer and this cancer when it is operated this boy is going to die. He should first be on my medication for even a year if they want this thing to be removed so that he regains energy. This people never listened to my advice. Hearing that it is cancer, they went and tested and found out that it is indeed cancer . . . They had money, so they moved to the hospital; from there they paid a lot of money and they operated the boy. They took him to India and he died, because the machines which were being used on him alone was a problem. They would have listened and let me detoxify”, (R8, Female, 40 – 49 years).