Demystifying Traditional Bonesetting: Lessons from Mbarara Regional Hospital

Globally, traditional bonesetters (TBSs) often provide patients with care for their orthopaedic concerns, from musculoskeletal injuries to oncological pathologies, often using techniques that may differ from Western methods. The aim of this study was to investigate the motivations for seeking care from a TBS, the types of treatments received, and the attitudes toward traditional bonesetting, and to determine any differences between patients with traumatic versus nontraumatic musculoskeletal pathologies.

We surveyed patients who presented to the Orthopaedic Outpatient Clinic at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda, who had previously seen a TBS for their orthopaedic concern, in order to determine their reasons for seeking care from a TBS and the impressions of their care.

This study included 168 patients: 109 presented with traumatic injury, and 59 presented with another orthopaedic concern. The trauma group had a higher monthly family income (p < 0.001) and a higher level of education (p = 0.006) than the nontrauma cohort. Treatments provided by the TBS included cutting or puncturing of the skin, locally applied herbs, casting, and other traditional methods. The greatest motivation for seeking traditional bonesetting among trauma patients was belief in its efficacy; the patients in the nontrauma cohort believed that a TBS could reverse the witchcraft or curse that had caused their ailment. Failure of management was the reason that was cited most by both the trauma and nontrauma groups for discontinuing treatment with a TBS.

Orthopaedic pathology influences the way that individuals seek traditional bonesetting and their motivations for doing so. For nontraumatic pathologies, superstitious beliefs and a belief in its efficacy play a role in the selection of traditional bonesetting. Additional surveys of individuals may further elucidate the outcomes of seeking care from a TBS.

Therapeutic Level V . See Instructions for Authors for a complete description of levels of evidence.