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The Nature of Medicine in South Africa: the Intersection of Indigenous and Biomedicine

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The Nature of Medicine in South Africa: the Intersection of Indigenous and Biomedicine THE NATURE OF MEDICINE IN SOUTH AFRICA: THE INTERSECTION OF INDIGENOUS AND BIOMEDICINE By Kristina Monroe Bishop __________________________________ A Dissertation Submitted to the Faculty of the SCHOOL OF GEOGRAPHY AND DEVELOPMENT In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY WITH A MAJOR IN GEOGRAPHY In the Graduate College THE UNIVERSITY OF ARIZONA 2010 2 THE UNIVERSITY OF ARIZONA GRADUATE COLLEGE As members of the Dissertation Committee, we certify that we have read the dissertation prepared by Kristina Monroe Bishop entitled The Nature of Medicine in South Africa: The Intersection of Indigenous and Biomedicine and recommend that it be accepted as fulfilling the dissertation requirement for the Degree of Doctor of Philosophy _____________________________________________Date: May 7, 2010 Paul Robbins _____________________________________________Date: May 7, 2010 John Paul Jones III _____________________________________________Date: May 7, 2010 Sarah Moore _____________________________________________Date: May 7, 2010 Ivy Pike Final approval and acceptance of this dissertation is contingent upon the candidate’s submission of the final copies of the dissertation to the Graduate College. I hereby certify that I have read this dissertation prepared under my direction and recommend that it be accepted as fulfilling the dissertation requirement. ________________________________________________ Date: May 7, 2010 Dissertation Director: Paul Robbins 3 STATEMENT BY AUTHOR This dissertation has been submitted in partial fulfillment of requirements for an advanced degree at the University of Arizona and is deposited in the University Library to be made available to borrower under rules of the Library. Brief quotations from this dissertation are allowable without special permission, provided that accurate acknowledgement of source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted from the author. SIGNED: Kristina Monroe Bishop 4 ACKNOWLEDGEMENTS I would like to acknowledge all those who helped me in my research. First, thanks to my adviser Paul Robbins for helping me discover the potential of this topic. I would also like to thank the other members of my committee, John Paul Jones III, Sarah Moore and Ivy Pike, for their time and effort in helping with this project. Thanks as well to Jennifer Rice, Paula Decker and Stephen Martin, and the anonymous reviewers who improved these papers. I would like to thank all the people who helped me in South Africa. At the University of Pretoria Prof. Jane Olwoch and the students and faculty in the Department of Geography, Geoinfomatics and Meteorology assisted me while I was conducting my research in Pretoria. Tanya Pretorius and Katty Vandenberghe, Jerry and Lungile Thela, Nomsa and Amos Jele, Athol and Melinda Stark, and Zodwa Mhlangu shared their homes and knowledge with me. The people of Mpuluzi, once again, welcomed me, as did those in Fernie, Ermelo and Metsemadiba. Of course, thank you to all the inyangas and sangomas , doctors, nurses and administrators who gave up some of their time and allowed me to peer into their lives, if only for a moment. I want to acknowledge my husband Corey and daughters Cora and Marietta. Not only were they willing to travel to the other side of the world with me so I could conduct this research, they gave up many evenings and weekends with me while I finished writing. Finally, thank you to Social and Behavioral Science Research Institute at the University of Arizona and the National Science Foundation who supported this research, without which this would not have been possible. 5 DEDICATION This dissertation is dedicated to my husband, Corey, and to my two daughters Cora and Marietta. 6 TABLE OF CONTENTS LIST OF FIGURES ......................................................................................................................... 9 ABSTRACT ................................................................................................................................... 10 CHAPTER 1: INTRODUCTION .................................................................................................. 12 Introduction ................................................................................................................................ 12 Research papers ......................................................................................................................... 13 Background ................................................................................................................................ 14 HIV/AIDS policy in South Africa ........................................................................................... 16 Health care delivery in South Africa ...................................................................................... 18 The Nature of Disease, the Role of the Patient ...................................................................... 20 History of South Africa .............................................................................................................. 22 Colonialism 1652-1910 .......................................................................................................... 22 The Early Twentieth Century 1899-1948 ............................................................................... 24 Health Geography, Vulnerability and HIV/AIDS in South Africa ............................................ 25 Nature/Society and Health ......................................................................................................... 27 Why South Africa? .................................................................................................................... 29 Research questions ..................................................................................................................... 30 CHAPTER 2: PRESENT STUDY ................................................................................................. 32 Dissertation overview ................................................................................................................ 32 Study One: Colonial Medicine in South Africa: The Regulation of Nature, Witchcraft and Stethoscopes ............................................................................................................................... 33 Overview ................................................................................................................................ 33 Methods .................................................................................................................................. 34 Findings ................................................................................................................................. 36 Study Two: Anglo American Media Representations, Traditional Medicine, and HIV/AIDS in South Africa: From Muti Killings to Garlic Cures .................................................................... 37 Overview ................................................................................................................................ 37 Methods .................................................................................................................................. 38 Findings ................................................................................................................................. 39 7 Study Three: the Integration of Dreams and Drugs: South Africa’s Effort to Regulate Traditional Medicine .................................................................................................................. 40 Overview ................................................................................................................................ 40 Methods .................................................................................................................................. 40 Findings ................................................................................................................................. 42 Discussion of broader findings .................................................................................................. 43 Conclusion ................................................................................................................................. 48 REFERENCES .............................................................................................................................. 49 APPENDIX A: COLONIAL MEDICINE IN SOUTH AFRICA: THE REGULATION OF NATURE, WITCHCRAFT AND STETHOSCOPES ......................... 54 Abstract ...................................................................................................................................... 55 Introduction ................................................................................................................................ 55 The Nature of Medicine ............................................................................................................. 57 The Regulations ......................................................................................................................... 61 Limiting the non-natural ............................................................................................................ 64 Bounded practice ....................................................................................................................... 69 Discussion .................................................................................................................................
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