**9. Mourning the disrespect of the indigenous medicine**

This stage refers to the process of lamenting the injustices that have been done by colonization and how this has affected the self-esteem and image of the indigenous practitioners in the communities, including the impact it had on their practices and traditions. It has been argued to be an important part of healing and preparing for moving forward. The years of assault upon and damage done to the minds of indigenous people, their traditions, values and belief systems were reported on literature.

The scars from years of colonization and the indoctrination of African people to disown their own ways of living and of health practices are still evident years after achieving independence from colonizers. The perception that traditional beliefs and practices belong to the dark ages and uncivilized societies appears to have resulted in a refusal to accept indigenous heath practitioner.

Even the so-called educated and liberated middle-class African health professionals have not been prepared to free themselves of the limitations of colonization. "The main challenge is the existing negative perceptions you have about us. This is more prevalent among the educated and middle-class people… consult secretively, with skepticism, doubts and pride…." as quoted by an indigenous member in the study by Nemutandani and others [4].

#### **9.1 Dreaming process**

*Public Health in Developing Countries - Challenges and Opportunities*

ing, (4) commitment and (5) action (**Figure 3**).

**8.1 Rediscovery and recovery process**

The process of decolonization requires a participatory approach which requires commitment from all stakeholders [12, 62, 63]. It begins with demystifying traditional healthcare practices and community empowerment through honest and open discussion about the need for allopathic healthcare practitioners to learn from indigenous health practitioners. The main objective is changing the mindset and attitudes of the colonized indigenous and allopathic health practitioners through a participatory process. The demystifying stage involves the five phases of a decolonization process [4, 12, 62]: (1) rediscovery and recovery, (2) mourning, (3) dream-

This is the first phase in the process of decolonization. Allopathic healthcare practitioners are encouraged to rediscover and recover their historical cultural practices, languages and identities. They are to rediscover the many traditional practices including traditional methods of preparation and packaging of medicines; reproductive health, indigenous, preventative, promotive and diagnostic measures; curative and rehabilitative practices; management of diseases and health promotion; lifestyle and dietary preferences; the status of women; music, ancestral drumming and dance and its influence on wellbeing; spirituality; types of traditional healers, traditional leadership; patient management and palliative care; and maternal and child health. Similarly, the colonized indigenous practitioners and communities should rediscover, interrogate and question the current status of their practices. Rediscovery and recovery give the oppressed and colonized people the ability to decontaminate their minds and thought process in which they can define their real world and problems associated with it. Indigenous practitioners should decide on their terms of references and rules for engagement among themselves and with others. In this case, allopathic healthcare practitioners go through the process of rediscovery and

**80**

**Figure 3.**

*Cyclical pattern of decolonization adopted from Nemutandani et al. [4].*

The third decolonization process involves dreaming in which the allopathic healthcare practitioners will allow the traditional healers to educate them about different possibilities of knowledge and skills that can still be helpful to offer alternative care. In the environment in which the dreaming should take place, two processes are required.

#### **9.2 Commitment process**

The allopathic healthcare practitioners should take on the positions of activism to advocate for incorporation of indigenous healthcare practices into the curriculum. They will therefore write monographs and textbooks to take the knowledge from tacit to explicit.

#### **9.3 Action process**

The last process in decolonization is the joint development of a plan of action by allowing indigenous health practitioners to build capacity among allopathic health practitioners. Dreams and commitments are translated into strategies for capacity building and skill transfer to ensure that their collaboration is sustainable.

The existing collaborations between the two health systems without understanding and acknowledging that the indigenous health system is a living science are not sustainable.

Finally, there are reports which found that allopathic and indigenous medicine are compatible in their sciences of treating and managing their patients. For example, allopathic health practitioners, using their existing biomedical knowledge of HIV-/AIDS-related illness, would set a course of treatment that emphasize antiretroviral medications and hospital treatment. On the other hand, indigenous

health practitioners, invoking existing knowledge of sicknesses caused by spirits, set a course of treatment that emphasize herbal medicines, sacrifices and ritual ceremonies to appease ancestors. It can be argued that both approaches are typical of all medical systems in that they "frame problems in relation to the solutions they have to offer" and how they understand it to be according to their existing knowledge as defined by their health system—in textbook or through ancestors.

In conclusion, any health intervention which disregards the existing community health beliefs, traditions and cultural practices is likely to be resisted passively by communities if not openly by creating parallel systems acceptable to the communities.

Despite the existing bias against indigenous health practitioners and the negativities associated with those consulting them, collaboration between allopathic health practitioners and indigenous health practitioners in the management of patients is certainly possible.

Reflection: Why is it that indigenous health sciences are not incorporated in the curriculum of most health professional training institutions in Africa? Despite the strong beliefs and practical experiences of both academics and students being products of indigenous systems, few seem capable of associating with it. One could conclude that the prevailing educational system does not encourage either students or academics to think for themselves but rather follow the path traveled by their Euro-centric predecessors, despite well knowing that their environment is different. There seems to be a deeply embedded western paradigm of reasoning among members of human research committees who seem to be fixated on whether similar research had been done and whether tried and tested methods are being followed.

Reflection: For a long time, when we go out for research, if we are honest enough, what we are gathering or we went out for is a collection of existing information and raw data. It's only when we process it in our university (standards) that we call it knowledge. There are many of us who still go out and do research that way; it is the habit of the heart and mind and the habit of relating to people, society and healers as objects.
