Traditional healers in Tanzania: the perception of malaria and its causes

The coordination of traditional and western medicine is still in its infancy in most African countries. Although there is much discussion about the contribution of traditional medicine and its practitioners, especially on the primary health care level, it has rarely be done in practice. This is probably due to the lack of knowledge of how to do it, because a serious attempt to include traditional medicine in health planning would presuppose that it is known what traditional medicine has specifically to offer for certain diseases/illnesses and how traditional healers manage such conditions. The aim of this study was to investigate the management of malaria by traditional healers in different areas in Tanzania. This included looking at the perception, the causation concepts and the knowledge about prevention of the disease/illness of malaria. For this purpose traditional healers were interviewed in different rural and urban places in Tanzania: in the Kilombero valley (Kilombero/Ulanga District), on the main island of Ukerewe (Ukerewe District), in the region near Bukoba town (Bukoba District) and in the settlement of Dar es Salaam (largest town of Tanzania). The results of the study show that most of the interviewed traditional healers were very familiar with the signs and symptoms relating to malaria, as it is defined by western medicine. Many healers were aware of different manifestations of malaria and attributed to them different local names, which match the scientific terms which describe the different types of Plasmodium falciparum malaria, such as cerebral malaria, clinical malaria or febrile type, and gastrointestinal type, respectively. Differences compared to western medical knowledge were found for concepts of causation, and in the fact that severe malaria in children may not be perceived as being associated with malaria.