A rooster walks amidst roots used in traditional healing at Mwanahija Mzee's clinic in Zanzibar, Tanzania
A woman moans as she attempts to release a djinn (spirit) from her body, while other women look on at the Shifaa Herbal clinic in Zanzibar, Tanzania. Most who go to the clinic believe that both physical and mental illnesses are caused by the presence of a djinn possession overwhelming the body. At the Shifaa Clinic, a Sheik (religious figure) recites passages from the Quran which–it is hoped–will help restore the patient's spiritual balance and drive the djinn out.
Malady of Spirits
In the 1970s, Tanzania implemented a nationalized healthcare policy based on its socialist ideologies. Despite this low-cost system, on the semi-autonomous Zanzibar archipelago– a former slave colony– nearly 84% percent of citizens continue to visit herbalists and Quranic faith healers for their medical needs, though there are western clinics within a 6 km range of every village. While the common Western conception is that people who patronize faith healers or witchdoctors are bound only by the weight of superstition, the reality on the archipelago is that people have made do with the limited options available.
The state of modern healthcare on the islands is so dismal that it’s widely accepted when someone goes to the hospital, they will most likely die. Patients and hospital administrators interviewed spoke of common misdiagnosis by medical personnel who–partly due to underfunding–can’t test their diagnostic hypotheses but prescribe medication based solely on their best guesses. Consistent with this, patients can be given the wrong medication for their unknown illness and thus don’t physically improve. This failing, in combination with the long wait times at hospitals & clinics, leads many patients to lose trust in Western medicine as practiced on the islands, leading to people instead choosing to rely on the time-tested traditions of herbalists and holy scripture that's been passed down through generations. It’s such that the notion of pain relief and remedy is predicated as much on the trust of communal bonds as it is on empirical health and well-being. As the traditional practitioners are members of the community, as well as individually have fewer patients than the hospitals, many can spend a longer time examining and talking with patients–though the herbs and recitations of the Quran are not necessarily always effective in treating the physical issues– but which nurtures a sense of comfort which is lacking outside of their care, particularly true in instances where there’s no known cure as with Down syndrome or neurological disease. In other cases, like with childbirth, there is an amalgamation of practices; Women see medical professionals just twice during the entire pregnancy for sonograms but do not meet with an obstetrician. Instead, they go monthly to a traditional healer for physical evaluations (breech position, fetal health checkups, etc) as well as to receive herbs that are believed to protect the growing fetus.
In 2008, due to the overwhelmingly high percentage of citizens that continued to frequent alternative healers, the government enacted the “Zanzibar Traditional & AlternativeMedicine Policy”, which requires registration and skills testing for each healer as well as sets guidelines to integrate their works into the legal scope of healthcare while working to centralize and vet the efficacy of their remedies.
Traditional healer, Mwanahija Mzee, massages a pregnant patient, Maryam Juma, 29. This is Maryam's 5th pregnancy though she has no children due to three miscarriages and one stillbirth. Both she and the healer believe the reason she hasn't as yet had a live birth is because a djinn (spirit) has attacked each fetus in utero. Maryam has also attempted to see Western doctors at the government hospital, but as they have no machines or testing equipment available to further investigate her reproductive system, they're at a loss as to the reason.
8-month-old, Muhammad Alid, with his mother Nadra in their living room. The baby has a distended belly button caused by an extreme incarcerated hernia as his internal organs push forward through the abdominal wall. Nadra initially took him to the government hospital which recommended surgery, but his mother was concerned the child would die under the knife as many others have been known to. Instead, Nadra has begun to seek care from the traditional healer, Bi Mwanahija, and is instead receiving herbal medicines to alleviate some of the pain associated with his condition.
Pages from the Quran used in healing
A sign giving directions at Mnazi Mmoja Hospital which is the largest government-funded hospital on the island of Zanzibar.
One-year-old Nurdiin, born with Down Syndrome sits on the couch of his home. He is the youngest child of his 43-year-old mother, Salha Abdallah, who has 7 children in total including him. The two of them go twice weekly to Mwanahija Mzee's traditional healing clinic to get the baby massages and teas that she believes help invigorate him. When Salha left the hospital after giving birth, the doctors there didn't explain anything about the chromosomal disorder to her, so she does what she can to keep the child from becoming too listless.
Two women thought to be possessed by dark djinn (spirits) have longer consultations with Sheik's Abdul Rahman & Sheik Nsoor. In an attempt to expel the djinnis, the Sheiks physically hold the women and speak angrily to the djinn inside of them. It is believed that the Sheiks have a power bestowed on them by Allah, that gives them special strength that the djinn are afraid of.
