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Exploring Indigenous Knowledge Practices Concerning Health and Well-Being: a Case Study of Isixhosa-Speaking Women in the Rural Eastern Cape

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Exploring Indigenous Knowledge Practices Concerning Health and Well-Being: a Case Study of Isixhosa-Speaking Women in the Rural Eastern Cape Exploring Indigenous Knowledge Practices Concerning Health and Well-being: A Case Study of isiXhosa-speaking Women in the Rural Eastern Cape. BY: Helen Yolisa Hobongwana-Duley Thesis presented for the Degree of Doctor of Philosophy In the School of Education Graduate School of Humanities University of Cape Town Supervisors Dr. Linda Cooper UniversityDr. Salma Ismail of Cape Town Professor Crain Soudien July 2014 The copyright of this thesis vests in the author. No quotation from it or information derived from it is to be published without full acknowledgement of the source. The thesis is to be used for private study or non- commercial research purposes only. Published by the University of Cape Town (UCT) in terms of the non-exclusive license granted to UCT by the author. University of Cape Town The financial assistance of the National Research Foundation (NRF) towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at are those of the author and are not necessarily to be attributed to the NRF. ii iii Dedication This thesis is dedicated to my parents, Aaron and Monica Hobongwana and to my grandparents Wilson Kulile Hobongwana and Miriam Ntumpuse Hobongwana. iv ABSTRACT This thesis explores, analyzes and conceptualizes the indigenous knowledge practices concerning health and well-being held by different generations of women and how they are reproduced cross-generationally in a rural isiXhosa-speaking community. It also explores how the relationship between concepts of self, personhood and Ubuntu informs women’s agency. Additionally, this thesis explores how the indigenous knowledge practices might have the potential to augment inclusive and relevant tools for learning for young women, girls and youth. This study adopts a critical, holistic and interpretive approach through an ethnographic case study. Qualitative data was gathered over an 18-month period, through ethnographic observations, informal interactions, semi-structured interviews and one focus group. Observations provided insight into the social structure of the community, women’s agency, and indigenous knowledge practices that support well-being. They also brought a greater awareness of the ways in which Ubuntu philosophy is embedded within indigenous practices that support individual and collective wellbeing. Interviews created a deeper understanding of women’s agency and the choices women make regarding well-being, and how knowledge practices are reproduced. Evidence from this study is presented and findings are analyzed drawing from Giddens’ critical theory, with emphasis on social structure and agency, the philosophy of Ubuntu, Engeström’s Cultural Historical Activity Theory (CHAT), literatures on indigenous knowledge practices and systems, and theories of informal and situated learning, in three chapters, each dealing with “the ecology of the homestead”; “health practices”; and “childbirth and childrearing” respectively. v Central findings indicate that indigenous knowledge practices are usually reproduced informally through rituals, ceremonies, and everyday tasks and skills for living within the homestead and are often situated in communities of practice. Other findings indicate that women choose biomedicine for childbirth while also using indigenous practices for health and well-being; NGO outreach workers and mentors often act as ‘boundary workers’, helping to narrow the boundaries between activity and knowledge systems. However, knowledge that is reproduced in more formal settings such as school often results in gaps in knowledge reproduction, especially among youth. Due to multiple knowledges being harnessed and reproduced simultaneously, this thesis concludes that different knowledges are practised, are valued and are integral to the choices women make around well-being, which illuminates the value of indigenous knowledge practices in facilitating cultural identity and ontological security. This thesis contributes to theories of knowledge and how knowledge and knowledge reproduction may be viewed and understood, particularly with regard to informal learning. These insights can be applied to developing curricula that acknowledge and are inclusive of indigenous knowledge practices, processes of informal knowledge reproduction and multiple knowledge practices or ways of knowing. vi TABLE OF CONTENTS Acknowledgements xii List of Abbreviations and Acronyms xiii CHAPTER ONE: INTRODUCTION TO THE STUDY 1 Indigenous Ways of Knowing and Education 3 Impact of Apartheid on Education 4 Developing an Idea for a Thesis 6 The Relevance of Life Skills in Education 9 Research Focus 10 Motivation and Purpose For The Study 11 Evolution of New Ideas and Analytic Constructions 13 Locating the Research 14 Developing Contact with Women in the Eastern Cape 15 Historical Context 16 The Village Community 17 Outline of the Thesis 17 CHAPTER TWO: REVIEW OF LITERATURE 19 Social Structure and Agency 21 Human Agency 23 Agency and Knowledge 24 Constructing the Self 25 Limitations to the Theory of Structuration 25 Ubuntu 26 Ubuntu in Relation to Personhood 28 Personhood 30 Indigenous Knowledge 34 Indigenous Knowledge Systems 34 Historical Context Of IKS 35 Recognizing Indigenous Knowledge Practices 37 Health and Well-being 39 Concepts of Health and Well-being 39 Measuring Well-being 40 Indigenous Healing Practices 41 Impact of Colonialism on Traditional Healing Methods 44 South African Law and Indigenous Healing 44 Reproducing Knowledge 46 Informal and Non-formal Learning 46 Situated Learning 46 vii Communities of Practice and Peripheral Participation 48 Cultural Historical Activity Theory 49 Conclusion: The Conceptual and Analytical Framework 55 CHAPTER THREE: METHODOLOGY AND RESEARCH DESIGN 57 Broad Methodological Approach 57 Critical Qualitative Research 57 Heuristic-Hermeneutic Research 58 Heuristic Approach 58 Hermeneutic Approach 59 Research Design 60 A Case Study Approach 60 The Ethnographic Approach 60 Data Collection 61 Planning the Fieldwork 61 Gaining Access to a Rural Community 62 A Serendipitous Encounter 62 The Site 62 Collecting Data 63 Observations 64 Participant Observation 65 Recording Observations 65 Field Notes 66 Interviews 67 Selecting Interview Participants 67 Language Medium and Interviews 69 Interview Questions 70 Ethical Considerations 70 Informed Consent 70 Anonymity 70 Analysis of Data 71 Early Analysis 71 Grounded Theory 71 Coding 71 Computer-coding 73 Second-Phase Analysis using Cultural Historical Activity Theory (CHAT) 74 Methods of Validating Data 77 Challenges to This Research 77 Locating Myself as a Researcher 78 Organization of Findings 79 CHAPTER FOUR: THE ECOLOGY OF THE HOMESTEAD 80 Introduction 80 viii Sacred Spaces 82 The Kraal (Ubuhlanti) 82 The Presence of Ancestors 85 Building and Maintaining a Homestead 86 Constructing a Hut 86 Making Bricks 86 Maintaining a Homestead 89 Accessing Water 93 The Importance of Firewood 94 Gardening and Agriculture 96 Preparing Umqombothi 97 Seed security 101 Imifino 103 Reproducing Knowledge and Skills 105 Maintaining Good Social Relations 105 Family Relations 105 Relations With the Ancestors 106 Gender and Power Structures within the Household 107 The Relationship between Ubuntu and Well-being 109 The Life-giving Land 110 Food Security 110 Shelter Security 111 Joining Two Homesteads through Marriage 112 The Historical Context 113 The Importance of Lobola 113 Preparing the Bride for Marriage 114 Handing the Bride to the Groom’s Family 122 Gender, Knowledge and Maintaining the Patriarchal 124 Gendered Knowledge Reproduction 126 Flexibility and Change 126 Conclusion 127 CHAPTER FIVE: HEALTH PRACTICES 129 Introduction 129 Traditional Health Practices 130 Igqirha (The Diviner/Traditional Healer) 131 Ukuthwasa: To Train as a Healer 133 Intwaso: The Call to Healing 133 Divination 136 Finding a Cure 138 Herbal Medicines and Charms 138 Seeking Treatment 139 Treating and Healing Women 139 Treating and Healing Children 141 ix Protecting a Family 143 Practising Cautionary Measures 143 Traditional Healers and Christianity 145 Tensions between the Church and Traditional Healing Practices 146 Cultivating Health and Well-being Through Traditional Healing Methods 148 Reproducing Knowledge and Skills 148 Ancestors’ Knowledge 148 Diviner’s Knowledge 149 Multiple Healing Practices in a Changing world 150 Biomedical Health Practices 150 Biomedical Diagnosis and Treatment 152 Antiretroviral Treatments (ARTs) 152 Maternity Health Care 153 ARV Interventions 157 Making Choices About Health Care 157 Reducing Tensions Between Two Healing Modalities 158 Recognition of Traditional Healers 159 Conclusion 161 CHAPTER SIX: CHILDREARING AND SOCIALIZATION 162 Introduction 162 Pregnancy and Childbirth 162 The Value of Children 162 Home Births 164 The Importance of Birth Rituals 168 Hospital Births 170 Antenatal Care 172 Postnatal Care 174 Accessing Quality Care at Mzingisi Hospital 176 Changing Perceptions of Care 177 Seeking External Support in Childbirth 177 Saving Lives with Biomedical Interventions 178 Childbirth Intervention 178 Caring for the Newborn Child 179 Indigenous Nutrition Practices 180 Breastfeeding Practices 183 Issues Surrounding Breastfeeding 184 Teenage Pregnancy 185 Three Young Women’s Stories 187 Barriers to Using Contraceptives and Unprotected Sex 188 Complexities Surrounding Teenage Pregnancy 189 Gender Inequalities in Sexual Relationships in Relation to HIV 191 Formal Education and Birth Control 193 x Filling the Knowledge Gap 194 Socialization of the Child 196 Educating the Young Child
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