Customary and Traditional Practices that can be Adapted and Useful in Coping with Covid
South Africa
Traditional Healers and Medicine
Traditional medicines are substances used in the traditional health practice for the diagnosis, prevention, and treatment of illness as well as the promotion of well-being in most rural African societies. They include a diverse range of plant and animal products that are either self-administered by the patient or administered by traditional healers and believed to treat a wide range of conditions including mental disorders, tuberculosis, and diabetes. For instance, the leaf of the Aloe Ferox plant has been shown to have anti-diabetic properties, the Ubulawu, a traditional medicine drawn from the stem of Helinus integrifolius and root of the Sillene bellidioides is used to cleanse the body and soul, while the Cryptocarya bark mixed with crocodile fat is used in the treatment of chest pains (Mmamosheledi & Sibanda, 2018).
Traditional healers are responsible for the administration of traditional medicine in South Africa and include traditional birth attendants, traditional surgeons, herbalists (iNyanga) and diviners (iSangoma) (Mmamosheledi & Sibanda, 2018). Traditional healing is interwoven with religious beliefs and cultural practices and is, therefore, believed to be holistic, involving both the mind and soul (Mmamosheledi & Sibanda, 2018). South Africans link traditional healing practices with spirituality and believe that traditional healers are capable of communicating with ancestors and an individual’s departed blood-relatives, who are believed to mediate between the living and God and who serve as the custodians of the destinies of living generations (Mmamosheledi & Sibanda, 2018).
For instance, diviners in the South African belief system are considered spirituality experts capable of defining and diagnosing the origin and reason of illness with the help of the patient’s ancestors (Mmamosheledi & Sibanda, 2018). The strong beliefs that traditional healers enjoy some form of spiritual connection with ancestors and God that could intervene in illness makes traditional healers the first treatment option for most patients, although patients also prefer them because they are more affordable. In the wake of the Covid-19 pandemic, traditional healers could help reduce the strain on the formal healthcare system by administering or guiding patients to self-medicate using traditional medicines such as Umckaloabo used in the treatment of chest pains and bronchitis symptoms (Mmamosheledi & Sibanda, 2013). Traditional healers and medicinal options are more affordable and readily available to rural populations than formal options such as Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), and would effectively help patients with mild symptoms manage the same at home.
Subsistence Farming and Food Security
Farming is one of the primary economic activities in South Africa. Traditionally, farmers practiced subsistence, organic farming, with households in rural areas mostly producing their own food and those in urban areas relying largely on market purchases. Recent years have, however, seen a shift towards market food purchases in both rural and urban households (Baiphethi & Jacobs, 2009). The disruption of food chains as a result of lockdowns and other measures geared at curbing the spread of Covid affects the availability of food substances in the market, increasing the risk of food insecurity, particularly among the urban dwellers who mostly rely on market food purchases. Moreover, it is estimated that food expenditures account for between 60 and 80 percent of total household income in an average Sub-Saharan African household (Baiphethi & Jacobs, 2009). The decline of food produce in the market as a result of disrupted food chains pushes food prices up, imposing a further strain on the urban poor who are already experiencing falling incomes as a direct effect of the pandemic.
In this regard, a return to the traditional subsistence farming would help increase food security for households, minimizing reliance on market food purchases (Baiphethi & Jacobs, 2009). Several actions have been taken to encourage local communities to shift back to subsistence farming. One such initiative is the partnership between organizations such as the Spire Wine Farm and Sustainability Institute, which seeks to train locals in Lynedoch area on how to use eco-friendly techniques to grow their on nutritious and fresh produce for consumption (Pretorious, 2020). Such moves towards increased subsistence farming help to increase the subsistence production of food items that have been shown to boost immunity and hence, minimize the risk of Covid-19. Further, by growing their own food produce, households increase their access to a balanced diet, which also increases their ability to manage the disease.
Informal Trade and Savings Cooperatives
Formal trade and savings cooperatives in South Africa are underdeveloped, particularly in rural areas where education levels are low and infrastructure poorly developed (Finmark Trust, 2013). Informal institutions that allow indigenous rural farmers without regular income streams to save and invest include informal saving groups, rotating savings and credit associations (ROSCA), and accumulating savings and credit associations (ASCAS) (Finmark Trust, 2013). They provide effective avenues for alternative investment when incomes are falling during crises, helping them to better cope in times of crises (Finmark Trust, 2013).
Marriage
The traditional wedding ceremony varies across communities. However, in the basic traditional setting, weddings only took place between members of different clans, which implies that the individuals had to have different clan names, although men were allowed to marry women from the same clan as their maternal grandmother (Siyabona Africa, 2020). For the two weeks preceding the wedding, the bride is secluded in a specially-constructed structure in her parents’ compound in a move designed to shield her from the eyes of men (Siyabona Africa, 2020). She stays in solitary seclusion for the entire period, with only a maiden designated to attend to her needs having direct access to her (Siyabona Africa, 2020). On the day of the wedding, she emerges from seclusion covered by an umbrella and completely wrapped in a blanket, which she adorns in addition to her marriage blanket (Siyabona Africa, 2020). At the end of the ceremony, the couple moves away from the bride’s village to settle in an area belonging to the husband’s clan (Siyabona Africa, 2020).
The two-week seclusion period helps in the management of Covid in that it minimizes social interactions between the bride and other people, helping her keep a safe physical distance. Further, the fact that the bride appears from seclusion completely covered in a blanket reduces her risk of contracting the disease. The movement away from the bride’s home area into an unfamiliar locality helps to minimize visits from family members, which reduces the couple’s risk of exposure to Covid-19.
Caring Models
The South African culture is founded on the Ubuntu framework, which emphasizes teamwork and collectiveness through the social values of survival, solidarity spirit, compassion, respect and dignity (Poovan et al., 20060. Like in most African societies, the family is the smallest unit of the South African society (Ghebregiorgis & Karsten, 2006). The extended family is an outgrowth of the individual family and is the social glue binding various interrelated families together (Ghebregiorgis & Karsten, 2006). The extended family forms the foundation of brotherliness under Ubuntu (Ghebregiorgis & Karsten, 2006). Members of the extended family are bound by the five values of Ubuntu, which implies that they need to work together as a team to address problems facing the family including illness, as well as caring for the vulnerable such as children and the elderly. Assuming that one gets infected with Covid, for instance, Ubuntu requires members of their extended family to come together in an integrated model of care. The value of survival requires the family and community members to pool their limited resources together to ensure that the patient receives the care and medication that they need to get better (Ghebregiorgis & Karsten, 2006). Employed members of the group have a duty to provide the financial support needed by the sick member of the extended family (Ghebregiorgis & Karsten, 2006). Similarly, healthcare professionals in the family and community have a moral duty to assist the patient through administering medication, monitoring progress, and offering medical advice.
The value of solidarity empowers them to share responsibilities and work cohesively in the making of effective decisions regarding the patient’s treatment (Ghebregiorgis & Karsten, 2006). Compassion requires them to place themselves in the patient’s position and to demonstrate empathy towards the patient (Ghebregiorgis & Karsten, 2006). The values of respect and dignity impose upon family and community members the duty to respect each other and treat each other with dignity regardless of their social status and contribution to the group’s shared vision (Ghebregiorgis & Karsten, 2006). Based on the dictates of the five social values of Ubuntu, a Covid patient is assured of proper familial and community-based care to help them get better.
Nigeria
Traditional Healers and Traditional Medication
Most Nigerians lack health insurance and are forced to pay for their health expenditures out-of-pocket (Nelissen et al., 2020). In 2016, for instance, 75 percent of healthcare costs among citizens were settled out-of-pocket for lack of insurance coverage (Nelissen et al., 2020). The lack of insurance coverage limits access to care (Nelissen et al., 2020). As such, it could limit the ability of citizens who contract Covid-19 to access formal healthcare. Most patients in Nigeria citizens prefer to consult informal healthcare providers including traditional healers and proprietary medicine vendors whenever they fall ill and require treatment (Nelissen et al., 2020). Studies have shown that patients’ visits to informal providers are independent of insurance status, leading to the conclusion that the decision to visit a traditional healer for treatment is most likely dictated by cultural beliefs that favor traditional medication over contemporary ones, and traditional healing over formal treatment (Nelissen et al., 2020). In this regard, traditional healers and informal medicine vendors selling traditional medicinal formulations that could aid in the treatment of Covid-19 symptoms could help uninsured patients with mild symptoms effectively manage the disease. Patients would be required to only seek formal healthcare when symptoms are severe enough to require hospitalization, reducing the strain on formal healthcare facilities. Further, self-medication is a common practice among citizens in rural Nigeria, particularly among older women with knowhow on herbal medications (Gbagbo & Nkrumah, 2020). Increasing access to extracts from the Acacia Nilotica tree, which are commonly used in the treatment of pneumonia, respiratory illnesses, and other illnesses whose symptoms resemble those of Covid-19 could be of great relevance (Okoro et al., 2014).
Subsistence Farming and Food Security
Subsistence agriculture is a fundamental component of rural Nigeria, with most households practicing small-scale farming to feed their families, while the urban dwellers mainly rely on market production. Subsistence farmers play a crucial role in food security with an average farm size ranging between 0.7 and 2.2 hectares (Apata et al., 2011). The Nigerian government has taken action to grow the country’s subsistence agriculture through the Structural Adjustment Program (SAP) tailored to enhance the capacity of small-scale subsistence farmers in a bid to ensure the country’s food security (Apata et al., 2011). With the pandemic, however, affecting food chains and limiting the availability of food in the market for urban dwellers, there is still a need to ensure food security. A cultural element that has been significant in promoting food security during the pandemic is commensality, which involves eating together with the less vulnerable in society as a sign of sharing and unity (Brager et al., 1987). Nigerian culture emphasizes unity – traditionally, people rarely eat alone as there always is someone with whom to share a meal in the compound (Brager et al., 1987).
People eat together in groups subdivided along lines of gender, generation or age, with the common meal serving as a medium for emphasizing kinship and building relationships. The Nigerian culture forbids the idea of a man having to break off a discussion with friends to go home for a meal with his family. The common meal tradition is meant to ensure that men eat together in unity and share all the information they need to share with each other. The common meal culture instills an aspect of sharing among Nigerians, which helps to ensure food security for all households during the pandemic.
Informal Trade and Savings Cooperatives
The saving culture in Nigeria is poor, particularly in the rural areas (Nwachukwu & Odigie, 2011). Formal banks in Nigeria have been shown to neglect the rural areas because of insecurity, poor educational levels, and poor infrastructure (Oluyombo, 2013). This leaves those in the rural areas underserved, particularly because the available institutions are largely microfinance institutions that emphasize lending and are irrelevant to customers who want to save (Oluyombo, 2013). The poor saving culture in the rural areas limits investment when people lose their jobs in times of crisis (Nwachukwu & Odigie, 2011). Cultivating a culture of saving and investment is one way by which citizens could be encouraged to save and later on, use their savings to begin investment opportunities that they could use to generate alternative incomes in times of crises. Informal trade and savings institutions have been shown to harbor significant prospects in stimulating savings and investments to help people cope better amidst falling revenue streams.
Marriage
As in most African traditional societies, Nigerian weddings involve exclusion of the bride to hide her from the eyes of preying men, and an appearance on the day of the wedding covered in a blanket. The blanket cover and seclusion both mitigate against the risk of Covid infection through protective clothing and social distancing respectively. However, a unique practice in Nigerian weddings that increases the risk of exposure to the disease is the ‘money spray’, where guests toss cash at the couple as they engage in their first dance. The fund is meant to help the couple obtain a fund with which to start off their married life. However, it enhances contact and poses a high risk of infection.
Caring Models
Community care provision is expected in Nigeria as was demonstrated in the Ebola crisis in 2014. Community care is provided via an integrated model involving the national government, the respective state government, non-governmental organizations, and international partners (Shuaib et al., 2014). Members of the public were empowered with information through the media on the symptoms of the disease and where to place reports on potential cases (Shuaib et al., 2014). Reports from members of the public were received by the case management team responsible for maintaining and linking reported patients with isolation wards. Once at the isolation ward, patients received coordinated care from trained physicians, attendants, and nurses (Shuaib et al., 2014). Contact-tracing was done through coordinated efforts involving patients, healthcare professionals and government officials under the government’s Social Mobilization Strategy (Shuaib et al., 2014). Staff under the Social Mobilization Strategy conducted door-to-door visits in neighborhoods with Ebola contacts to educate the public on ways of protecting themselves and how to care for the affected (Shuaib et al., 2014). This coordinated model of care involving various agencies at the community level would go a long way towards helping local communities manage the spread of the Covid-19 pandemic.
Further, parenting in the traditional Nigerian society is a shared responsibility extending beyond the extended family into the general community. The role of bringing up a child is carried out by the community as is that of taking care of the sick and the vulnerable in the population.
Swaziland
Traditional Healers and Traditional Medicine
Swaziland’s cultural practices are quite similar to those of South Africa. Citizens largely prefer traditional healers to formal medical practitioners as they are more affordable and available, particularly in rural Swaziland (Mahomoodally, 2013). Herbalists are responsible for prescribing traditional medicine that are mainly drawn from plants and animal parts (Mahomoodally, 2013). The popularity of traditional healers is linked in part to cultural beliefs that associate such healers with African spirituality (Mahomoodally, 2013). Traditional medicines are commonly used in patients with HIV/AIDS, although their effectiveness is unsupported (Mahomoodally, 2013). However, common traditional medicinal components such as the gum of the A. Senegal have been shown to be effective in the treatment of bronchitis, respiratory tract infections, typhoid, leprosy, gonorrhea, and bronchitis (Mahomoodally, 2013). These traditional medicines and healers provide avenues for alternative treatment, particularly because most of the older people in the rural areas are known to self-medicate and can self-treat in the case of pain or mild Covid symptoms (Gbagbo & Nkrumah, 2020; Okoro et al., 2014; Gurib-Fakim et al., 2010).
Subsistence Farming and Food Security
Subsistence farming is a key economic activity in rural Swaziland, and a key contributor to food security. Urban households largely depend on market food purchases, with demand fluctuating whenever food chains are affected by crises. However, the tradition in Swaziland as in most African countries emphasizes community parenting as way of bringing up healthy communities (Asiseh, Owusu & Quiacoe, 2017). Children and adolescents learn by observing their elders act – strategies that influence households to engage in small-scale subsistence agricultural production thus provide crucial avenues for promoting subsistence farming across generations and ensure food security in times of crises.
Informal Trade and Saving Cooperatives
Formal trade and savings cooperatives in Swaziland are underdeveloped, particularly in rural areas where education levels are low and infrastructure poorly developed (Simelane & Odhiambo, 2018). Formal institutions such as banks may not effectively serve the needs of indigenous populations in rural Swaziland (Simelane & Odhiambo, 2018). Informal institutions that allow indigenous Swazi farmers without regular income streams to save and invest – including informal saving groups, rotating savings and credit associations (ROSCA), and accumulating savings and credit associations (ASCAS) – provide effective avenues for alternative investment when incomes are falling during crises, helping them to better cope when disrupted food chains make it impossible for them to effectively transport their food produce to the urban areas (Simelane & Odhiambo, 2018).
Marriage
Seclusion of the bride for several days as she is educated on how to maintain a successful marriage is a common feature of traditional weddings in Swaziland, locally referred to as Umtsimba. Further, as is the case in South Africa, the bride is covered in a blanket at the time of their presentation on the wedding day, and goes on to live with her husband away from her clan as men are not allowed to marry from their paternal clans. Both of these elements help to minimize contact, and hence the risk of exposure to the virus.
Caring Models
Swaziland is based on the Ubuntu humanist thought, which advocates for brotherliness and communal living (Martin et al., 2011). In the sense of brotherliness, members are expected to be each other’s keeper such that taking care of the aged, the sick, and the vulnerable is a shared responsibility for the extended family and the community by extension. Communities are taught to demonstrate the values of Ubuntu, which call for compassionate care and solidarity with the less privileged. In the event of sickness, members of the extended family are expected to come together and pool resources to ensure that the patient has access to the care they need.
References
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Baipethi, M. N., & Jacobs, P. (2009). The Contribution of Subsistence Farming to Food Security in South Africa. Center for Poverty Employment and Growth.
Brager, G., Specht, H., Torczyner, J. L., &Torczyner, J. (1987). Community organizing. Columbia University Press.
Finmark Trust (2016). Understanding Financial Cooperatives: South Africa, Malawi & Swaziland. Finmark Trust.
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Gurib-Fakim, A., Kasilo, O. M., régional pour l’Afrique, B., & World Health Organization. (2010). Promoting African medicinal plants through an African herbal pharmacopoeia. African Health Monitor, 64-67.
Gurib-Fakim, A., Brendler, T., Phillips, L. D., & Eloff, L. N. (2010). Green Gold—Success Stories Using Southern African Plant Species. Association for African Medicinal Plants Standards (AAMPS) Publishing, Mauritius
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Okoro, S. O., Kawo, A. H., & Arzai, A. H. (2012). Phytochemical screening, antibacterial and toxicological activities of Acacia senegal extracts. Bayero Journal of Pure and Applied Sciences, 5(1), 163-170.
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