**8. Development of sustainable collaborations through decolonization processes**

Studies show that the integration of allopathic and traditional medicine should include co-learning and mutual respect [19, 55, 56]. Traditional and allopathic healthcare practitioners already have common practices, for example, the physiotherapists' use of steam for inhalation therapy which is similar to ukugquma and using a warm towel compress which is similar to ukuthoba. Midwives recommending alternative positions during delivery is similar to methods used by traditional birth attendants throughout the ages.

Creating opportunities for collaboration and capacity development through training of allopathic healthcare practitioners in traditional healthcare practices is emancipatory, will stimulate awareness and creates a cultural sensitivity among allopathic healthcare practitioners [50, 57]. Collaboration will create an opportunity to enhance the transfer of skills and sharing of knowledge between the traditional and allopathic healthcare sectors [58, 59]. It should translate into curriculum transformation through co-teaching, co-supervision and transfer of knowledge on diagnostic measures applied by indigenous practitioners in preparation and packaging of traditional medicines. Through such a training process, trust will be fostered between the traditional and allopathic healthcare sectors, and co-operation will be facilitated, leading to sharing of critical information and ultimately empowerment of both types of healthcare practitioners [60].

Indigenous communities, through colonization, have been oppressed, stripped of human dignity and have died inside a long time ago. Existing collaborations have failed to recognize the importance of redressing the inequalities of the past and to acknowledge the importance of indigenous knowledge [4]. It is the belief that the experience gained when indigenous and allopathic health practitioners work alongside each other would result in lasting collaborations. The view has been expressed by indigenous scholars that decolonization of healthcare requires a change in mindset and the establishment of agendas that would allow for mutual exchange and recognition of indigenous knowledge [61]. The success of it relies on a change in attitude, recognizing the value of indigenous health systems, beliefs and the Ubuntu spirit in African communities.

*Public Health in Developing Countries - Challenges and Opportunities*

medicinal products, beliefs and practices. Some solutions are yet to be explored and discovered. Reports confirmed that indigenous health practitioners have perfected the art of sciences long before colonizers and missionaries introduced western medicine. Their processes of diagnosis and patient management are documented as

Despite what Felkin witnessed as being no different, in principle at least, from what modern doctors do, allopathic health practitioners of the twenty-first century do not recognize that indigenous health systems are a science and could play a significant role in existing health systems. There are several factors which contributed to poor working relationship between the two systems. Key among them is the effect and impact of colonization, globalization and commercialization of health and healthcare services as a commodity. Indigenous communities were encouraged to abandon their practices, beliefs and sciences. High levels of suspicion and mistrust supported the enforcement by law that prohibited the use of indigenous medicines. There is no doubt that the impact of colonization extended beyond politics and the economic life of indigenous communities, for it disorientated and destabilized their psychosocial interactions with reality. There are perceptions that most scientific scholars raised and educated according to the western doctrine are unable to use their worldview to interrogate and interpret the world and environment, unless it meets the western worldview. They subscribe to western principles despite its limitations in African settings. While most of the colonized countries may have achieved political freedom from their erstwhile masters, the pervasive socioeconomic mindset persists and liberation from western scientific inclinations evades

**Figure 2** Allopathic health practitioners of the twenty-first century applying similar principles, protocol and standards to that of indigenous health practitioners reported by medical anthropologist in 1885 during the delivery of a baby through

The author argues for the need of a different approach to collaboration with indigenous communities who have experienced centuries of colonization and

**7. Exploring the indigenous epistemologies and sustainable** 

being thorough, scientific and of comparable standard to other practices.

*Allopathic health practitioners of the twenty-first century performing caesarean delivery.*

**78**

indigenous scholars.

**Figure 2.**

**collaborations**

Cesarean section (Google source).

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

#### **8.1 Rediscovery and recovery process**

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

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*Understanding the Science of Indigenous Health System: Key to Sustainable Collaborations*

and identities. This process is the cornerstone for sustainable collaboration.

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

in a refusal to accept indigenous heath practitioner.

study by Nemutandani and others [4].

**9.1 Dreaming process**

processes are required.

from tacit to explicit.

**9.3 Action process**

are not sustainable.

**9.2 Commitment process**

recovery through learning about existing traditional healthcare practices, languages

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

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

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

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

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

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

*DOI: http://dx.doi.org/10.5772/intechopen.92090*

**Figure 3.** *Cyclical pattern of decolonization adopted from Nemutandani et al. [4].*

recovery through learning about existing traditional healthcare practices, languages and identities. This process is the cornerstone for sustainable collaboration.
