The Influence of Culture on the Cause, Diagnosis and Treatment of Serious Mental Illness (Ufufunyana): Perspectives of Traditional Health Practitioners in the Harry Gwala District, KwaZulu-Natal.

Cultural beliefs influence the perceived cause, methods of diagnosis and treatment of mental illnesses. A qualitative study was conducted among traditional health practitioners (THPs) in the Harry Gwala District Municipality to further explore this influence. Purposive sampling assisted in the recruitment of 31 participants (9 males and 22 females). The four key themes this study investigated in relation to mental illness included its causes, methods of diagnosis, common symptoms observed and treatment approaches used by THPs, and the system of patient management. Culturally, mental illness was reported to be caused by witchcraft and an ancestral calling in this study. Mental illness was predominantly diagnosed by spiritual intervention which included divination through consultation with the ancestors, familial background, burning of incense which can also be part of communicating with the ancestors and through examining the patient. The common symptoms included aggression, hallucination and unresponsiveness. Prevalent modes of treatment included the use of a medicinal concoction and performing cultural rituals where ancestors and other spirits were assumed influential. The duration of the treatment process was dependent on guidance from the ancestors. Most causal aspects of mental illness from diagnosis to treatment seemed to be influenced by cultural beliefs and ancestors.

Global perspectives on the traditional approaches used in the treatment of schizophrenia: A systematic review.

BACKGROUND: Traditional healing considers a holistic approach when diagnosing and treating patients for mental ailments, and is the preferred approach globally. OBJECTIVE: This review documented traditional healing approaches for treatment of schizophrenia used in different regions globally. METHODS: PICO framework was used to facilitate literature search from Google Scholar, PubMed, Medline, Cochrane, Scopus, APA PsycINFO, and Web search. Studies documenting methods of treatment from the perspective of traditional healers, patients and/or caregivers were included and also studies which investigated herbal plants used in traditional healing in vitro and in vivo were included. Review articles, magazine/newspaper articles, editorials, letters, comments/opinion articles, and articles with inaccessible full text were excluded. The risk of bias was assessed using MMAT and SYRCLE tools. University Capacity Development Programme funded this review. RESULTS: 74 articles were included, these documented traditional healing practices used in Africa, Asia, America, Europe, and Oceania. Common approach globally was herbal medicine. Other reported methods included faith-based healing, consultation with the ancestors, performing rituals, acupuncture, and music and yoga therapies. Inhumane approaches included starving, beating, cutting and confining patients. In some cases, traditional healing was used as adjunctive treatment. The overall risk of bias for studies in this review was low. CONCLUSION: Traditional healing contributes in bridging the treatment gap for schizophrenia in developing countries. However, there is a lack of standardisation of the approaches employed in the different regions, and the safety and effectiveness of some of these approaches remain questionable.

Cultural practices of the Zulu ethnic group on the body and their influence on body donation.

Cultural practices in the African continent have been thought to impact negatively on body donation. Thus, most African countries continue to rely on unclaimed bodies for dissection programs, or bequests from the white population. The latter situation is dominant in South African medical schools. Since South Africa is multi-cultural with nine main ethnic groups of the Black African population, it is important to seek the reasons behind lack of participation in body donation. This report represents a move in this direction with its qualitative study of the cultural practices of the Zulu ethnic group in the province of KwaZulu-Natal from the perspective of a variety of participants, with emphasis on their treatment of the human body after death. Four themes emerged from interviews: (1) Death is not the end; (2) Effect of belief in ancestors; (3) Significance of rituals and customs carried out on human tissue; and (4) Burial as the only method of body disposal. Each of these themes is discussed in relation to the likelihood of body donation being seen by Zulus as an acceptable practice. It is concluded that this is unlikely, on account of the need to preserve the linkage between the physical human body and the spirit of the deceased person, and the perceived ongoing relationship between the spirit of the dead and the living. In view of these conclusions, a number of options are canvassed about the manner in which anatomists in KwaZulu-Natal might obtain bodies for dissection. These possibilities have implications for anatomists working in comparable cultural contexts.

Anatomical variations of the anterior belly of the digastric muscle / Variaciones anatómicas del vientre anterior del músculo digástrico

A routine dissection of the digastric muscle reflected that it originated by two muscle bellies namely. the anterior and posterior belly which are connected by an intermediate tendon (IT). These bellies originated from the mastoid process of the temporal bone and the digastric fossa of the mandible respectively. The digastric muscle serves as an important surgical landmark in surgical interventions involving the submental area however, accessory bellies may interfere with surgical intervention in this area. Therefore, this study aimed to document the occurrence of the anatomical variations in the anterior belly of the digastric muscle (ABDM) in a selected number of cadaveric samples. Ten bilateral adult cadaveric head and neck specimens (n = 20) were macro-dissected in order to document the morphology of the digastric muscle. The accessory bellies in the ABDM was observed in 60 % of the specimens. Unilateral and bilateral variations were observed in 20 % and 30 % of the specimens, respectively. These accessory bellies originated in the digastric fossa, ABDM, IT and hyoid bone, and inserted into the mylohyoid raphe, mylohyoid muscle and hyoid bone. In addition, an anomalous main ABDM was observed in 10 % of the specimens inserting through a transverse tendon into the hyoid bone. Variations in the digastric muscle are common especially the accessory bellies, therefore, a comprehensive understanding of these anatomical variations could be of clinical importance to the surgeons during head and neck radiological diagnosis and surgical interventions.

Una disección de rutina del músculo digástrico refleja que se éste originaba por dos vientres musculares, anterior y posterior conectados por un tendón intermedio (IT). Estos vientres se originaban a partir del proceso mastoide del hueso temporal y de la fosa digástrica de la mandíbula, respectivamente. El músculo digástrico sirve como un hito quirúrgico importante en las intervenciones que involucran el área submental. Sin embargo, los vientres accesorios pueden obstaculizar la intervención quirúrgica en esta área. Por lo anterior, este estudio tuvo como objetivo documentar observaciones de las variaciones anatómicas en el vientre anterior del músculo digástrico (VAMD) en un número seleccionado de cadáveres. Las muestras consistieron en 10 cabezas y cuellos cadavéricos de individuos adultos, estudiadas bilateralmente (n = 20). Estas muestras fueron disecadas para documentar la morfología del músculo digástrico. Los vientres accesorios en el VAMD se observaron en el 60 % de los casos. Se observaron variaciones unilaterales y bilaterales en el 20 % y el 30 % de las muestras, respectivamente. Estos vientres accesorios se originaban en la fosa digástrica, VAMD, IT y hueso hioides, y se insertaban en el rafe milohioideo, el músculo milohioideo y el hueso hioides. Además, se observó un VAMD principal anómalo en el 10 % de las muestras que se insertaban a través de un tendón transversal en el hueso hioides. Las variaciones en el músculo digástrico son comunes, especialmente los vientres accesorios, por lo tanto, un conocimiento completo de estas variaciones anatómicas podría ser de importancia clínica durante el diagnóstico radiológico de cabeza y cuello y en las intervenciones quirúrgicas de la región.