Global Concepts and Local Context: Could Traditional Healers Assist in Mental Health Services in Zimbabwe?

By Amos Mareverwa, Marc Van der Putten

All countries face a gap between the prevalence of mental disorders and the proportion of those affected receiving care. This gap is particularly wide in low- and middle income countries (LMIC).
  The recognition of this gap triggered a global movement calling to address the issue especially in LMICs. However, there are critical challenges in adopting Western steered recommendations in LMICs that ignore indigenous systems. Root causes of ill mental health, although not exclusively, are often nested in the societal fabric while traditional practices present indigenous ways of knowing. Simultaneously, LMICs face multiple barriers in the provision of mental health services. This paper questions whether traditional healers could assist in developing socio-culturally appropriate mental health services, while also providing a pathway in overcoming some of the existing challenges. A literature review resulted in the selection of 135 publications including scientific papers, and reports from international organizations and the Government of Zimbabwe that are available in the public domain. These provided an analysis of key issues, including: relevant LMIC development and policy challenges; varying views on ill mental health and healing; bridging the divide between Western and traditional medicine models by moving from competing to complementing. The findings point to common challenges for mental health service development in LMICs and illustrate a growing interest in exploring traditional healers practices, ethical issues, outcomes of traditional practice illustrate traditional healers efficacy in identifying mental health issues (i.e., most of those diagnosed by healers had a DSM-III-R mental disorder) suggesting healers might indeed be capable of correctly identifying cases in their communities. The paper arrives at the proposition that traditional healers are an important part of the indigenous system and advocates that those responsible for mental health should engage with traditional healers and explore potential ways of partnering in service delivery in Zimbabwe and beyond.