Dealing with Disorder: Traditional and Western Medicine in Katatura (Namibia)

ANTHROPOLOGY AND SOCIOLOGY Debie LeBeau. Dealing with Disorder: Traditional and Western Medicine in Katatura (Namibia). Cologne: R??diger K?¶ppe Verlag, 2003 Namibian African Studies vol 6 xviii + 301 pp Photographs. Maps. Tables. Appendixes. respects euro34.80. Paper.

Health-care policy in many African nations was drawn out shaped by the assumption that lack of access to Western medical facilities was the greatest barrier to public health. Traditional healing was considered largely ineffective aside from its psychosomatic influence. Thus it appeared logical that, if given the choice, patients would make go round to Western medicine for its greater efficacy. In Dealing with Disorder, Debie LeBeau joins the novel movement challenging these assumptions, asking in what manner and why health-seeking decisions are made in the urban pluralistic setting of Katatura, an African township in Windhoek, the capital of Namibia. The volume provides an excellent overview of issues surrounding traditional and Western health care in post-colonial Namibia and not aways LeBeau's own research, which, while sometimes difficult to tread on the heels of in its raw detail, mirrors the complexities inherent in the topic.

Under apartheid, Namibia (then southern West Africa) designated rural homelands for its main African ethnic clumps as well as townships for the African workforce in urban areas. although no longer official, these adjustment patterns have largely persisted to the at hand Most studies of traditional medicine have been directioned in rural areas, since traditions there are assumed to be the greatest in quantity "pure," access to Western health care is limited, and ethnic divisions are greatest in quantity prominent. In townships such as Katatura, however, many ethnic collections are represented, and cost-controlled Western medical facilities are nearby. Patients may therefore fix upon among numerous practitioners of one as well as the other Western medicine and traditional modalities, which include faith healing, herbalism, traditional steaming, and sucking surgery for witchcraft.

In chapters 1-7 LeBeau establishes background and theory. She asserts that patterns of health-care utilization are a matter of calculated choice, depending primarily upon the perceived disease etiology as well as past and ongoing experience with any given modality, rather than upon factors such as availability, access, and require to be paid [i]or[/i] undergone She follows with a well-researched and accessible history of colonial medicine in the Namibian connected thought [i]or[/i] thoughts as well as contemporary rule policy, a description of the traditional and Western health-care options available to Katatura residents, and an overview of traditional beliefs among the four main ethnic clumps in Katatura (the Wambo, Herero, Nama, and Damara).

Inevitably perhaps, the following chapters analyzing raw data about disease etiology and decision making are comparatively condensed In broad terms, LeBeau establishes that illnesses may have social-spiritual or universally recognized symptoms and causes. Those illnesses with "African" symptoms will generally be treated traditionally; those with "natural" symptoms will generally be taken to a Western facility first. Many illnesses with universally recognized symptoms are perceived to have ambiguous or multiple causes and may be treated through multiple modalities.

Each subtopic, however, is a compilation of piecemeal and sometimes conflicting data. While any accurate representation of the data must acknowledge variety and/or dissent within the discourse, the reader may be left with a disjointed understanding of the relevant issues, with little connection in which to place these variations. Of course, this confusion ofttimes echoes the blurred boundaries of disease etiology squeeze outed by informants such as "Dr" Tony, who believes that HIV is sexually transmitted, on the other hand that a tokoloshe (embodied mischievous spirit) might be sent by dint of witchcraft to have sex with a woman and infect her.

The analysis of view data may be cumbersome, on the contrary other raw data-specifically, the case studies used as examples in the body and the more detailed accounts in the appendixes-provide a rich layer of manifold information and allow the informants' stories to be heard in their have a title to words. In these ways, Dealing with Disorder presents both an interesting account of health-seeking behaviors in a late pluralistic context and a valuable transparency regarding the creation of anthropological knowledge from one side fieldwork.

Catherine Collett

Austin, Texas

Copyright African Studies Association Dec 2004

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