KUOMA RUPANDI (The Parts Are Dry)
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KUOMA RUPANDI (The parts are dry) Deliane Jannette Burck Ideas and practices concern ing disability and rehabilitation in a Shona ward Research Report no. 36/1989 African Studies Centre Leiden/The Netherlands KUOMA RUPANDI (The Parts Are Dry) Ideas and practices concerning disability and rehabilitation in a Shona ward "1 «, ~ " ««s-rs!:*^ « &?1 !, ^5 t , i door Deliane Jannette Buick Afrika Studiecentrum, Leiden 1989 KUOMA RUPANDI Contents Preface 1. General introduction to and description of the problem 1. Introduction 3 2. Outline of the research activities 6 3. Practical problems faced during the fieldwork-period 8 4- Outline of the research report 11 5. Relevance 12 2. Introduction to the fieldwork area 1. General introduction 13 2. The economie Situation 14 3. Administrative structure and organization 15 1. General introduction 15 2. The structure of the health care system 18 3. The religieus structure and organization 20 4- The cultural setting 22 5. The history of the land and its people 24 3. Introduction to the modern component of the medical system in the fieldwork area, with particular reference to disability and rehabilitation 1. Definitions and theories concerning disability and rehabilitation 29 2. Statistical information concerning the disabled population in Zimbabwe in general and in the fieldwork area in particular 34 CIP-gegevens Koninklijke Bibliotheek, Den Haag 1. The national disability survey of Zimbabwe, 1981 34 Burck, Dekane Jannette 2. SociO'economie data associated with paraplegia 35 3. Care ofphysically handicapped chïldren in Rhodesia 36 Kuoma Rupandi (The parts are dry): ideas and practices concerning disability and rehabilitation in a Shona ward / Deliane Jannette Burck - Leiden: African Studies 4. Stat/stica! data concerning the population in Chinamora Centre. - Research reports / African Studies Centre; 36) Ook versehenen als proefschrift Leiden. - Met lit. opg. communal lands 37 ISBN 90-70110-72-5 3. Historical development of the modern component of the medical SISO 612.1 UDC 615.851.3:3-056.26(689.1) 39 Trefw.: gehandicapten; Zimbabwe / gehandicapten ; revalidatie; Zimbabwe. system in Zimbabwe, with particular referenee to rehabilitation VI Vil 4. Introduction to the traditional component of the medical 8. The (social) position of disabled persons System in the fieldwork area 1. Four case-studies 129 1. Introduction 47 2. Factors influencing the position of disabled persons in the 2. The Gods and the natural elements 136 48 community and the prospects for rehabilitation 3. The realm of'culture': human beings and their spirits 51 1. General conditions of life and Problems faced by disabled l. Human beings 136 51 persons 1. The spirits 137 52 2. Economie position 3. The spirit mediums 142 55 3. Education 4. Illness as a cultural and religious phenomenon and the preference 4. Family life 143 145 for scientinc or traditional, healing 59 5. Politica/ status 5. References in the literature concerning the traditional attitude to- 6. Cultural and religious position 146 149 wards illness and misfortune in general and disability in particular 60 3. Disability and liminality 5. Theoretical Framework 9. Summary of data, points for analysis and recommendations 1. Summary of the literature study 153 69 1. Summary of data obtained 2. The medical System 159 71 2. Points for analysis 162 3. Questions posed for the research, an elaboration 75 3. Conclusions 4. Präsentation of the research data 165 78 4. Recommendations 6. Illness and disability, the populär perspective Notes 169 1. Four case-studies 81 2. The informants Appendix: A summary of the case-studies 191 89 3. General nature and causes of disability as indicated by the Samenvatting 209 disabled informants and relevant others 92 211 4- Terminology for and causes of disabilities as mentioned by Bibliography disabled informants, their relatives and relevant others 96 5. Preliminary conclusions concerning the way disabilities are experienced and perceived by disabled persons, their relatives and relevant others 103 7. The diagnosis and treatment of disability, the professional perspective 1. Four case-studies 105 2. Traditional healers approached 110 3. Terminology concerning disease and disability 113 4. Diagnosis and treatment 122 5. Preliminary conclusions concerning the diagnosis and treatment of disability by traditional healers 126 Preface 'There is a tree rooted in African sou, nourished with the waters from the rivers of Africa. Come and sit under its shade and become, with us, the leaves of the same branch and the branch of the same tree.' (R. Mangaliso Sobukwe) From 1984 to 1987 I worked in Zimbabwe as a psychologist. On account of my work I came in touch with many disabled persons, most of them living in the rural areas. Some contacts developed beyond the sphere of work and led to the research which forms the basis of this study. Since my return from Zimbabwe and while I was writing this thesis, I have been working in The Netherlands in a nursing home for, mainly, elderly persons. The experiences were so different and at the same time so much related that they almost tore my head apart. It seemed as if there were two conflicting series of slides in my head, one series diffusing the other. I remember Maxwel, who would crawl all the way to the river to fetch water for his tomato plants; I hear people complain about the fact that the elevators are not wide enough to allow for the easy entrance of electric wheelchairs. When in my present work I witness how people await death each in his or her own way, I recall the dignified way in which amai Mapfure among her ten children and nfty-seven grandchildren started her career as an ancestor spirit. Health is a fascinating issue. It forms the beginning of Maslov's staircase and makes for many a pitfall on the way. This study reflects my understanding of a small piece of the puzzle that health continues to be. Although I am solely re- sponsible for everything mentioned in the text, many people contributed to the process of understanding, while others rendered valuable practical assistance. First of all I would like to thank all the disabled persons, their relatives, Community members and the traditional healers, for sharing with me their ideas and experiences on the subject. They allowed me to ask silly questions, to make wrcng assumptions and to come back a week later to start all over again. Equally grateful am I to Mr. B. T Gudyanga and Mr. Jambaya, who accompa- nied me on many of my visits to disabled persons and traditional healers. To say L PREFACE they were Interpreters or assistants would be inadequate. They often knew the next 'question' in an interview before I did. pter l Professor G. Chavunduka was kind enough to supervise the research in Zim- babwe and to comment on the research material. His advice and comments as Introduction to and description of the problem well as his assistance in solving practical problems were highly appreciated. Professor Schoffeleers greatly encouraged me to carry the project through without too much delay after my return from Zimbabwe. His elaborate com- ments on the first, second and final draft helped me to see many inconsistencies in my thinking about the subject. Professor H. Tïeleman provided very valuable comments to the second and 1.1. ïntroduction third draft and helped me to shape up the conclusions. Itis an acknowledged fact that about 10% of any given population is disabled.1 Dr. S. van der Geest read all the drafts and gave very elaborate comments and This means that in Africa alone there are more than 50 million disabled persons. advice both on the content and on the form of the text. In addition hè helped No less than 80% of the disabled population lives in isolated rural areas in the me to clarify some of the theoretical issues underlying the research. devetoping world (United Nations 1982:13).2 Tbwards the finalization of the study, I had the opportunity to discuss with Mr. The range of medical, socio-psychological, educational and vocational mea- T Shoko, who is preparing a thesis on a related subject. He made very valuable sures designed to 'serve' disabled people is commonly termed 'rehabilitation'. comments and suggestions concerning the final draft and corrected some of the During the 1960s and 1970s institutional rehabilitation services were developed Shona terminology. in most countries in the Southern African region, often with fmancial and The content of this thesis was one thing, getting it into print was something professional assistance from western donors. These services cater to only a small ^ else altogether. I am most grateful to the African Studies Centre in Leiden for percentage of the disabled population, although they use up the larger part of the their willingness to take care of the reproduction of the book and to include it l budgeted rehabilitation funds. Institutional rehabilitation is generally directed in their Research Reports series. towards persons sufFering from the more severe physical and mental disabilities. And then there are my relatives and friends who apparently had this antenna But the majority of the disabled population is left unserved, particularly disabled through which they could feel, even when I was in Zimbabwe, when my spirits persons living in rural areas. In reaction a new approach to rehabilitation were low and when I needed cheering up, encouraging letters, spare parts for the was developed, generally called community-based rehabilitation. lts Intention car, a decent meal and assistance with operating the personal computer. The is to serve disabled persons right in the Community where they live, making secondary gains of thesis writing are indeed enormous, I wonder how life will be use as much as possible of the knowledge, services, facilities and experience without them.