Traditional healing system faces challenges of being lost and slid into oblivion
Photo: iStock In Andrahal village of Odisha’s Malkangiri district, the nearest healthcare facility is over 10 kilometres away. In case of any minor ailments, the 315-odd households seek remedies from within their village.
Members of the Bonda tribe, a Particularly Vulnerable Tribal Group, rely heavily on traditional healers or dissahris for treating general and minor ailments in this village.
A traditional healer can be defined as a person without formal medical training but is considered (by the local tribal community) competent to provide healthcare using animal, plant and mineral substances.
They use techniques based on their social, cultural and religious background as well as the knowledge, attitudes and beliefs prevalent in the community regarding disease and disability.
Reliance on traditional healers is a common practice across tribal communities. And as PVTGs are classified for their vulnerable status and their health remains a constant concern, the traditional healthcare system gains prominence as modern medicinal practices make inroads.
This dependence remains even in villages that now have better and easier access to formal and modern healthcare systems. But despite its prominence within the tribal healthcare practice, the traditional healing system faces challenges of being pushed into oblivion.
Studies from across the globe have shown that tribal groups have their own unique ways of defining health and disease and also dealing with health issues. Almost all these communities have traditional healers who provide the connection between man and nature and the divine.
However, the traditional knowledge of the tribal traditional healers is at the risk of being lost, now more than ever before.
Times are changing and people have started migrating out for work. Their exposure to modern health practices is inevitably much more, said Maladi Jakasia, aged 67, a traditional healer from the Dongria Kondh tribe.
“The trust in traditional medicine is immense, but someone who lives away in a town or a city would always approach the nearest odern medical facility. And we never stop them. But if this trend continues, the younger generation will lose interest in this system and eventually wane out,” said Jakasia.
The community members believe the present healers have very limited knowledge of the treatments and medicines their ancestors practised. In Andrahal village alone, there are seven traditional healers, all aged 60 and above and all male.
The healing practices are divided into three types: Soni, rau and pangan.
The villagers claim that soni deals with cases of fits and paralysis, rau cures cases of extreme malnourishment and weakness and pangan deals with instances where they feel that a person has been looked upon. For all three types of practices, animal sacrifice is mandatory.
Herbs necessary for healing are slowly vanishing with degrading forests, said a traditional healer from Andrahal.
A lot of our dried herbs could be preserved for a year, but it’s not the case anymore. Most medicinal herbs that we know of are not present in the surrounding jungles anymore. Even if the knowledge is transferred to the next generation, where will they find the right herbs?”
The traditional healers in most of these tribes are self-chosen. Through interactions, we learnt that, in most cases, the traditional healer identifies himself after dreaming about it.
In certain tribes, the healers are identified based on their astrological prominence. As the idea of identification remains abstract, the question of sustaining these practices remains.
A major question that arises from these practices is the efficacy of dealing with major ailments and the delays it causes. As it remains, the first point of healthcare remedy sought, diagnosis and subsequent treatment of many diseases get delayed, leading to deteriorating health parameters and mortality.
Sambari Krisani, an ASHA worker for over 17 years in Andrahal, reiterates the same.
“It is important to monitor their health conditions continuously. In case of fever, they refer to a traditional healer. But fever is technically a symptom of many diseases and if not medically tested on time, it can delay treatments and worsen the situation,” she said.
“I do not dissuade them from reaching out to a traditional healer, but I also urge them to take medicines simultaneously and also consult a doctor if the situation does not stabilise in a few days,” Krisani said.
In Gonasika village of Keonjhar’s Banspal block, members of the Juang community are prone to malaria. In malaria cases, the first point of contact is a traditional healer despite the nearest healthcare facility being just two km away.
“Malaria is very common in our village. In villages where we have an ASHA didi or an Anganwadi didi, they make sure that people take medicines. But in most cases, the first point of contact is a traditional healer. Some cases are cured, some deteriorate and seek admission in a hospital,” said Geetanjali, a native of the village and the first girl to graduate from her village.
In certain cases, people also rely on quacks masquerading as healers, jeopardising traditional practices.
“Earlier, every village had more than one traditional healer; today, it’s one in three villages. We have developed an understanding that branding a child with a hot iron rod will not cure any disease but can be fatal for the infant. They aren’t the traditional healers we should promote or go to,” said Kajal, a native of Tadakaipur, belonging to the Paudi Bhuyan tribe.
Experts also feel that better documentation of effective traditional medicines can help preserve these practices and eliminate non-scientific practices.
“They have traditional practices and within these, there are scientific and non-scientific practices. Certain roots or tubers yield results, but some of the other practices have negative results,” said Biswajit Modak, a public health expert with a focused study on PVTGs and their healthcare practices.
The effective traditional medicines should be documented with scientific evidence and accordingly, materials can be prepared to create mass awareness to modify their health-seeking behaviours, Modak added.
Given the dependency of the tribal people on the healers, it is imperative to preserve their knowledge in order to maintain a healthy tribal population and preserve the endangered yet priceless knowledge of the tribal healers.
“One must remember that the traditional health healers in tribal societies are extremely key community influencers. Sidelining them and trying to introduce a modern healthcare system will not yield much results,” AB Ota, former director for Scheduled Castes and Scheduled Tribes Research and Training Institute, Odisha, said.
Taking the healers into confidence will really address accessing government-run healthcare facilities more meaningfully, he added.
A study specific to traditional healers and the PVTG community found that the connection between traditional healers and the public health system was non-existent.
In Odisha, however, traditional healers are being engaged as opinion leaders to make this integration.
“At the village level, we have constituted committees to monitor health and sanitation parameters. As a part of these committees, we try to rope in these traditional healers to share their knowledge and provide community-based insights for better implementation of community-based initiatives,” said Bijay Mohapatra, director of public health, Odisha government.
Premium institutes are also conducting studies to integrate traditional wisdom into the modern healthcare system.
Considering that integrative medicine is one way to converge traditional healing practices with modern medical practices, the convergence can be an essential strategy for improving patient outcomes in healthcare, specifically for PVTGs.
“By doing so, healthcare providers can increase patient trust and satisfaction and help bridge the gap between traditional and modern medical practices,” Dr KC Sahoo, a public health expert, said.
The data revealed five obstacles to integration: A lack of understanding of traditional medicine, discrimination, high biomedical staff turnover, waning interest in healing as a profession and equipment shortage, he said.
Through cultural competency training and integrative medicine, healthcare providers can provide a more individualised and holistic approach to care that combines the best of both worlds, Sahoo added.
This is the final part of the three-part series exploring the healthcare systems amongst the Particularly Vulnerable Tribal Groups of Odisha. You can read the part 1 here and the part 2 here.
This article was supported by Health Systems Transformation Platform as a part of HSTP — Health Journalism Fellowship 2022.
We are a voice to you; you have been a support to us. Together we build journalism that is independent, credible and fearless. You can further help us by making a donation. This will mean a lot for our ability to bring you news, perspectives and analysis from the ground so that we can make change together.
.png)
Comments are moderated and will be published only after the site moderator’s approval. Please use a genuine email ID and provide your name. Selected comments may also be used in the ‘Letters’ section of the Down To Earth print edition.