|dc.description.abstract||The purpose of the study was to analyze the process of facilitating collaboration between
traditional healers and western trained health care workers in the management of chronic illnesses,
hypertension and diabetes. This process was facilitated through qualitative participatory action
research which utilized the principles of Action Science Enquiry. This was a qualitative research.
Two phases were as followed: phase one was the analysis of the problem of collaboration while
phase two was the implementation of strategy one and two. Strategy one was the development of
the constitution of traditional healers towards the establishment of the Swaziland traditional
Healers' Council and a traditional healers' department within the Ministry of Health and Social
Welfare. Strategy two was a small comparative survey into the safety and efficacy of traditional
medicine. The survey compared clients who utilized only traditional medicines and those who
utilized only western medicines to control their hypertension.
Data was collected through interviews, meetings, observations and clinical measurements.
Audio-taped and field notes were transcribed, carefully studied and analyzed. The editing analysis
described by Crabtree and Williams (1992) was utilized in the analysis of data.
The results of phase one was a descriptive profile of traditional healers and the way
hypertension and diabetes were managed by the traditional healers and the western trained health
care workers, with the aim of finding out how they could collaborate. A number of barriers for
collaboration were identified such as the lack of a legal body of traditional healers, negative
attitudes of western trained health care workers towards clients and traditional healers, ethical
issues, perceptions of illnesses and payments as well as the lack of transparency. Enhancers for
collaboration were also identified. Consequences of a successful collaborative process were
established by the participants. Strategies to solving the problems of collaboration were identified
and two of the strategies were implemented. A traditional collaborative model was identified and
compared to an existing modem collaborative model.
Phase two, strategy one, the legalizing of traditional healers in Swaziland, was decided upon
during one of the meetings held between traditional healers, clients and western trained health
care workers. Barriers to successfully organize this strategy were also identified, such as
organization and exclusion, leadership style, traditional and cultural structures, lack of resources,
poor communication and different traditional healers' categories. Action plans to solve those
problems were developed and progress was made. The end result was that a draft of the
traditional healers' constitution content was developed. Stakeholders who would be part of the
development of the constitution were contacted. The stakeholders included the Ministry of
Health and Social Welfare, the Ministry of Natural Resources and Agriculture, the Swaziland
World Health Organization, the Ministry of Justice and the University of Swaziland. The
traditional healers managed to form an interim committee called the Traditional Healers'
Constitution Development Committee. This committee was still in a process of involving all
traditional healers in Swaziland to furnish their views and opinions to the committee concerning
the constitution. The target date for the constitution to be completed was set to be around April,
2001. The researcher will still be working with the committee until the legalizing process is
completed. This would take another one year to complete.
Phase two : strategy two, establishing the efficacy of traditional healers' medicines to control
hypertension was established to enhance trust between the traditional healers and the western
trained health care personnel. From the small sample, it would seem that fluctuations of blood
pressure levels were similar between the two groups. This showed that traditional healers
medicines to control hypertension in Swaziland is effective. Though it was difficult to establish the
safety of those clients who utilized only the traditional medicines, there were no abnormalities
discovered to be associated with the use of the traditional medicines.||en