3 - Negotiating the search for diagnosis and healing tuberculosis in Namibia. A case study of a Ju/’hoansi speaking man.
African Sociological Review,
Vol. 14 No. 2 (2010): African Sociological Review
Abstract
This case study of tuberculosis among Ju/’hoansi speakers in a small village in Otjodzondjupa
district, namibia, shows how different notions concerning tuberculosis and TB-like complaints
become a area of uncertainty and even contention in a situation where tuberculosis education is
good but diagnostics, and by extension treatment, are not always easily accessible. The paper
argues that culturalism in the health services turns attention away from the socio-economic and
political aspects of tuberculosis. it furthermore shows that Ju/’hoansi speakers have to turn to
plant medicines to deal with their ill health when the interface with the health care ser- vices
become problematic. Plants are understood as standing in a particular relationship with humans andwith nature as well. Yet the use of plant medicines is also a terrain of medicinal knowledge andpractice contested by the health care services as potentially unsafe and counter- productive to TB treatment.
Keywords
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- Barad, K., 2007, Meeting the universe halfway. quantum physics and the entanglement of matter and meaning. Durham: Duke University Press.
- Beyers, N., 1999, Impact of social interactions in the community on the transmission of tuberculosis in a high incidence area. Thorax, 54, pp.136-140.
- Biesele, M., 1993, Women like meat: The folklore and foraging ideology of the Kalahari Ju/’hoan. Bloomington: Indiana University Press.
- Biesele, M., 2004, Speaking truth to a powerful film: engaging with a representation of an indigenous people. Anthropology news, 8-9.
- Chinsembu, K., 2009, Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia. Journal of ethnobiology and ethnomedicine 2009, 5:30.
- Classen, C., Warren, R., Richardson, M., Hauman, J., Gie, R., Ellis, J., van Helden, P., De Villiers, S., 1991. Tuberculosis in anthropological perspective. South African Journal of Ethnology, l4, p. 69.
- Farmer. P., 1999, infections and inequalities. The modern plagues. Berkeley: University of California Press.
- Farmer, P., 1997, Social scientists and the new Tuberculosis. Social Science and Medicine 44, 3, pp 347-358.
- Fassin, D., Rechtman, R., 2005, An anthropological hybrid: The pragmatic arrangement of universalism and culturalism in French mental health. Transcultural Psychiatry, 42, 3, pp.347-366.
- Foucault, M., 1998, The Will to Knowledge, The history of Sexuality volume 1, Hurley, R., trans., Penguin Books, Great Britain.
- Gibson, D & Oosthuysen, E., 2009, Between n!a†xam and tibi. A case study of tuberculosis and the Ju/’honi in the Tsumkwe region, Namibia. Anthropology Southern Africa, 32, 1&2, pp. 27-36.
- Gordon, R., 1992, The Bushman myth. The making of a namibian underclass. Boulder, San Francisco and Oxford: Westview Press.
- Grange,J and Zumla, A., 1999. Tuberculosis and the poverty-disease cycle. Journal of the Royal Society of Medicine, 92(3): 105–107.
- Green, E., Samie, A., Obi, .M., Bessong, P., Ndip R., 2010, Inhibitory properties of selected South African medicinal plants against Mycobacterium tuberculosis. Journal of ethnopharmacology, 130, 1, pp.151-7.
- Greene, J., 2004. An ethnography of nonadherence: Culture, poverty and tuberculosis in Urban Bolivia. Culture, Medicine and Psychiatry, 28,3,401, pp.401-425.
- Health Unlimited., 2003, indigenous peoples. health issues. Summary of presentation at indigenous peoples and socioeconomic rights expert workshop. March 20th-21st. Available on http://www.cpsu.org.uk/downloads/Health%20 Issues.pdf. Accessed 13/02/07.
- Lee, R., 1979, The !Kung San. Men, women and work in a foraging society. Cambridge: Cambridge University Press.Lee, R. 1993, The Dobe Ju/’hoansi (Case Studies in Cultural Anthropology). New Orlando Florida: Harcourt (2nd edition).
- Lee, R., Biesele, M and R. Hitchcock (Eds.), 2002, The Kalahari San: Self- Determination in the Desert. Cultural Survival quarterly, 26, 1, pp.1-60.
- Lee, R. and Susser, I., 2002, Confounding conventional wisdom: Women’s power and low hiv/AiDS rates among the Ju/’hoansi of namibia and Botswana.
- Paper presented at the XIV International AIDS Conference in Barcelona.
- Leffers, A., 2003, Gemsbok bean & Kalahari truffle. Traditional plant use by Ju/’hoansi in north-eastern namibia. Windhoek: Gamsberg Macmillan.
- Leger, S., 1997, The hidden gifts of nature. A description of today’s use of plants in West Bushmanland. Windhoek: ded, German Development Service, Lock, M. And Nguyen, V., 2010, An anthropology of biomedicine. Malden, MA: Wiley-Blackwell.
- Low, C., 2009, Khoisan Medicine in history and Practice , Research in Khoisan Studies volume 20, Koln: Rüdiger Köppe Verlag.
- Marais, B., Pareker, S., Verver, S., van Rie, R. and R. Warren., 2009, Primary and Postprimary or Reactivation Tuberculosis: Time to Revise Confusing Terminology? American Journal of Roentology, 192 W198. Available online. http://www.ajronline.org/cgi/content/full/192/4/W198. Accessed 18/08/2010.
- Marshall, L., 1976, The !Kung of naye naye. London: Cambridge University Press. Marshall, L ., 2000, nyae nyae !Kung Beliefs and Rites.Cambridge MA: Peabody Museum Press.
- McGaw, L., Rabe,T., Sparg, S., Jäger, A., Eloff, J., van Staden, J., 2001.
- An investigation on the biological activity of Combretum species. Journal of ethnopharmacology, 75, 1, pp. 45-50.
- Okeleye, B., A. Samie, A., Bessong, O., Mkwetshana, N., Green, E., Clarke, A. and R. Ndip., 2010.
- Crude ethyl acetate extract of the stem bark of Peltophorum africanum (Sond, Fabaceae) possessing in vitro inhibitory and bactericidal activity against clinical isolates of Helicobacter pylori.
- Journal of Medicinal Plants Research,. 4, 14, pp. 1432-1440.
- Richardson, M., Carroll, N., Engelke, E., van der Spuy, G., Salker, F., Munch, Z., Gie, R., Warren, R., Beyers, N. and P. van Helden., 2002, Multiple Mycobacterium tuberculosis Strains in Early Cultures from Patients in a High-Incidence Community Setting. Journal of Clinical Microbiology,40, 8, pp. 2750-2754.
- Rival, L., McKey, L., 2008, Domestication and diversity in Manioc (Manihot esculenta Crantz ssp. esculenta, Euphorbiaceae) . Current Anthropology ,49, 6, pp.1119-1128.
- Susser, I., 2003, Ju/’hoansi survival in the face of HIV: Questions of poverty and gender. Anthropologica, 45: 120-128.
- Sibeene, P., 2008, Namibia: Drug Resistant TB Strain Confirmed. new era, 16th May. Available on http://allafrica.com/stories/200805160540.html. Accessed 18/06/2008.
- Shostak M., 1981, nisa. The life and words of a !Kung woman. London: Allen Lane Sonnenberg, P. Murray, J. Shearer, S., Glynn, J., Kambashi, B. Godffrey-Fauset, P., 2000, Tuberculosis treatment failure and drug resistance— same strain or reinfection?
- Tropical Medicine & hygiene. 94, 6, pp.603-607.
- Susser, I., 2003, Ju/’hoansi survival in the face of HIV: Questions of poverty and gender. Anthropologica, 45, 1, pp.121-128. Suzman, J. 1999.
- “Things from the Bush”. A contermporary history of the Omaheke Bushmen. Klosterberg: Schlettwein Publishing.
- Suzman, J., 2001, An introduction to the Regional Assessment of the Status of the San in Southern Africa. Windhoek, Namibia: Legal Assistance Center.
References
Barad, K., 2007, Meeting the universe halfway. quantum physics and the entanglement of matter and meaning. Durham: Duke University Press.
Beyers, N., 1999, Impact of social interactions in the community on the transmission of tuberculosis in a high incidence area. Thorax, 54, pp.136-140.
Biesele, M., 1993, Women like meat: The folklore and foraging ideology of the Kalahari Ju/’hoan. Bloomington: Indiana University Press.
Biesele, M., 2004, Speaking truth to a powerful film: engaging with a representation of an indigenous people. Anthropology news, 8-9.
Chinsembu, K., 2009, Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia. Journal of ethnobiology and ethnomedicine 2009, 5:30.
Classen, C., Warren, R., Richardson, M., Hauman, J., Gie, R., Ellis, J., van Helden, P., De Villiers, S., 1991. Tuberculosis in anthropological perspective. South African Journal of Ethnology, l4, p. 69.
Farmer. P., 1999, infections and inequalities. The modern plagues. Berkeley: University of California Press.
Farmer, P., 1997, Social scientists and the new Tuberculosis. Social Science and Medicine 44, 3, pp 347-358.
Fassin, D., Rechtman, R., 2005, An anthropological hybrid: The pragmatic arrangement of universalism and culturalism in French mental health. Transcultural Psychiatry, 42, 3, pp.347-366.
Foucault, M., 1998, The Will to Knowledge, The history of Sexuality volume 1, Hurley, R., trans., Penguin Books, Great Britain.
Gibson, D & Oosthuysen, E., 2009, Between n!a†xam and tibi. A case study of tuberculosis and the Ju/’honi in the Tsumkwe region, Namibia. Anthropology Southern Africa, 32, 1&2, pp. 27-36.
Gordon, R., 1992, The Bushman myth. The making of a namibian underclass. Boulder, San Francisco and Oxford: Westview Press.
Grange,J and Zumla, A., 1999. Tuberculosis and the poverty-disease cycle. Journal of the Royal Society of Medicine, 92(3): 105–107.
Green, E., Samie, A., Obi, .M., Bessong, P., Ndip R., 2010, Inhibitory properties of selected South African medicinal plants against Mycobacterium tuberculosis. Journal of ethnopharmacology, 130, 1, pp.151-7.
Greene, J., 2004. An ethnography of nonadherence: Culture, poverty and tuberculosis in Urban Bolivia. Culture, Medicine and Psychiatry, 28,3,401, pp.401-425.
Health Unlimited., 2003, indigenous peoples. health issues. Summary of presentation at indigenous peoples and socioeconomic rights expert workshop. March 20th-21st. Available on http://www.cpsu.org.uk/downloads/Health%20 Issues.pdf. Accessed 13/02/07.
Lee, R., 1979, The !Kung San. Men, women and work in a foraging society. Cambridge: Cambridge University Press.Lee, R. 1993, The Dobe Ju/’hoansi (Case Studies in Cultural Anthropology). New Orlando Florida: Harcourt (2nd edition).
Lee, R., Biesele, M and R. Hitchcock (Eds.), 2002, The Kalahari San: Self- Determination in the Desert. Cultural Survival quarterly, 26, 1, pp.1-60.
Lee, R. and Susser, I., 2002, Confounding conventional wisdom: Women’s power and low hiv/AiDS rates among the Ju/’hoansi of namibia and Botswana.
Paper presented at the XIV International AIDS Conference in Barcelona.
Leffers, A., 2003, Gemsbok bean & Kalahari truffle. Traditional plant use by Ju/’hoansi in north-eastern namibia. Windhoek: Gamsberg Macmillan.
Leger, S., 1997, The hidden gifts of nature. A description of today’s use of plants in West Bushmanland. Windhoek: ded, German Development Service, Lock, M. And Nguyen, V., 2010, An anthropology of biomedicine. Malden, MA: Wiley-Blackwell.
Low, C., 2009, Khoisan Medicine in history and Practice , Research in Khoisan Studies volume 20, Koln: Rüdiger Köppe Verlag.
Marais, B., Pareker, S., Verver, S., van Rie, R. and R. Warren., 2009, Primary and Postprimary or Reactivation Tuberculosis: Time to Revise Confusing Terminology? American Journal of Roentology, 192 W198. Available online. http://www.ajronline.org/cgi/content/full/192/4/W198. Accessed 18/08/2010.
Marshall, L., 1976, The !Kung of naye naye. London: Cambridge University Press. Marshall, L ., 2000, nyae nyae !Kung Beliefs and Rites.Cambridge MA: Peabody Museum Press.
McGaw, L., Rabe,T., Sparg, S., Jäger, A., Eloff, J., van Staden, J., 2001.
An investigation on the biological activity of Combretum species. Journal of ethnopharmacology, 75, 1, pp. 45-50.
Okeleye, B., A. Samie, A., Bessong, O., Mkwetshana, N., Green, E., Clarke, A. and R. Ndip., 2010.
Crude ethyl acetate extract of the stem bark of Peltophorum africanum (Sond, Fabaceae) possessing in vitro inhibitory and bactericidal activity against clinical isolates of Helicobacter pylori.
Journal of Medicinal Plants Research,. 4, 14, pp. 1432-1440.
Richardson, M., Carroll, N., Engelke, E., van der Spuy, G., Salker, F., Munch, Z., Gie, R., Warren, R., Beyers, N. and P. van Helden., 2002, Multiple Mycobacterium tuberculosis Strains in Early Cultures from Patients in a High-Incidence Community Setting. Journal of Clinical Microbiology,40, 8, pp. 2750-2754.
Rival, L., McKey, L., 2008, Domestication and diversity in Manioc (Manihot esculenta Crantz ssp. esculenta, Euphorbiaceae) . Current Anthropology ,49, 6, pp.1119-1128.
Susser, I., 2003, Ju/’hoansi survival in the face of HIV: Questions of poverty and gender. Anthropologica, 45: 120-128.
Sibeene, P., 2008, Namibia: Drug Resistant TB Strain Confirmed. new era, 16th May. Available on http://allafrica.com/stories/200805160540.html. Accessed 18/06/2008.
Shostak M., 1981, nisa. The life and words of a !Kung woman. London: Allen Lane Sonnenberg, P. Murray, J. Shearer, S., Glynn, J., Kambashi, B. Godffrey-Fauset, P., 2000, Tuberculosis treatment failure and drug resistance— same strain or reinfection?
Tropical Medicine & hygiene. 94, 6, pp.603-607.
Susser, I., 2003, Ju/’hoansi survival in the face of HIV: Questions of poverty and gender. Anthropologica, 45, 1, pp.121-128. Suzman, J. 1999.
“Things from the Bush”. A contermporary history of the Omaheke Bushmen. Klosterberg: Schlettwein Publishing.
Suzman, J., 2001, An introduction to the Regional Assessment of the Status of the San in Southern Africa. Windhoek, Namibia: Legal Assistance Center.