On March 31, Pamela Okello was awakened by a crash of saucepans, plastic drums, drums, and whistles. The sound came from Pader, a small city tens of kilometers away. Okello did not have a mobile phone or the Internet. She couldn't speak to the people of that city. But right away, this 53-year-old peasant identified the bustle with an ancient ritual known as ryemo gemo . He also understood her message: a major danger was near. She had to protect herself. Stay alert. Limit your movements. Immediately, Okello's family banged on their saucepans to make the noise reach other towns in northern Uganda. They wanted to scare away an evil, invisible, terrifying spirit, prepared to weaken our bodies to death: the covid-19.
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The cultural leaders of northern Uganda say that this ritual was, in addition to a way of asking the pre-colonial gods for their protection, a method of alerting communities to the presence of the pandemic and the need to take health regulations seriously. that the government proposed. However, President Yoweri Kaguta Museveni disapproved in a televised speech. According to the president, recognizing the pandemic as a spirit may have confused the population.
At that time, Uganda had detected 33 cases of covid-19. Many were transporters from other countries, so medical personnel settled at the Ugandan borders to examine them one by one. The government acted quickly: when the disease landed in this nation, the authorities closed air traffic to prevent the entry of more infected passengers and prohibited internal displacement, among other drastic measures.
According to experts from the Centers for Disease Control and Prevention in Africa, they made the right decisions. But, to make these standards more effective, the Uganda Transcultural Foundation (CCFU) proposes to the Government to consider the social and cultural contexts of each people, and to identify cultures as tools against the pandemic.
For Simon Musasizi, one of the heads of the CCFU, imitating responses to covid-19 designed elsewhere is not a practical choice. "Cultures determine how we act," he says. “We have been culturally encoded since we were born. Culture provides us with a special lens for understanding pandemics and how to react to them. Strategies to contain them should take this approach into account. ” Uganda's cultures, Musasizi insists, have elements to fight the coronavirus.
Native medicine, a popular alternative
Alfonse Bifumbo, an 82-year-old traditional doctor, was born at a time when Africa's borders were little more than ridiculous lines that European colonizers had outlined on their maps. Bifumbo walked without caring if his sandals stepped on Uganda or the Democratic Republic of the Congo. He was much more concerned with distinguishing forest plants and their medicinal properties. Both his grandfather and father were native doctors.
After school, where Belgian priests taught him to speak French, he spent the afternoons with his grandfather, discovering the fascinating world of plants. His training began shortly after his seventh birthday, when his relatives began to send him to the bush to collect medicinal plants. "At first I didn't like it," admits Bifumbo. “But little by little my interest increased. I felt great every time I healed a person. "
The peoples of East Africa have overcome numerous infectious diseases, but the elites ignore this knowledge.
In the town of Buhoma in southwestern Uganda, everyone knows the way to Bifumbo's house. His home, a single humble room surrounded by banana trees, is on the landing of a hill that rises to two thousand meters. In a small garden, Bifumbo plants some plants that he will later use with his patients. Others are wild. So sometimes you have to walk for hours to find them. His graying beard contrasts with the agility with which he moves. He is used to using his slim legs. Until 2003, when American missionaries opened a hospital in Buhoma, this indigenous doctor was the only option for the region's sick.
In rural Uganda, healers like Bifumbo are more popular than modern medicine. In many cases, the medicines offered by local doctors are cheaper than those dispensed in hospitals. On the other hand, while traditional doctors are respected members of the communities and reside in them, the health centers may be tens of kilometers away from the villages. The World Health Organization (WHO) recommends at least 23 doctors for every 10,000 inhabitants, but Uganda has 0.91 doctors for every 10,000 inhabitants.
In 1987, the Ugandan National Organization for Health Research (UNHRO) discovered that despite the disastrous state of the Ugandan health system at the time, people's health was not as poor as might be expected thanks to the hands invisible from indigenous healers. Since then, authorities have proposed some programs to license traditional doctors, register and research their treatments, establish a council to regulate their practices. Without these steps, Ugandans will remain exposed to untrained healers or some dangerous practices, lament indigenous medical associations.
The dark side of this scenario are entrepreneurs who offer miracle cures for diseases like cancer or HIV. Without a robust healthcare system at their disposal, Ugandans desperate to find a solution to their problems can sacrifice their savings or even borrow money to buy those products. It is a business in which foreign companies sometimes also participate, as Al Jazeera demonstrated in a documentary.
The footprint of colonialism
Pandemics have shaped the peoples of Africa, the cradle of humanity. Over five million years, parasites and diseases that harm people's bodies evolved on this continent, next to us, adapting to the adaptations of our organisms. According to anthropologist John Reader, "diseases that affect humans are exceptionally abundant in Africa."
When the first humans migrate to other regions we also free ourselves from them. We found different ecosystems, where the microorganisms that decimated African populations did not exist. While migrant populations in these settings rapidly multiplied before other ailments appeared, in Africa, clustering of many people in confined spaces was still synonymous with pandemics: high population densities facilitated the spread of disease. So there were hardly a few cities in Africa before the colonial period. "For centuries, infectious diseases have significantly changed how and where we live, our economies, our cultures, and our habits," says Musasizi. "They have influenced our settlement patterns, the size of our communities, our marriage and funeral traditions," he adds.
Infectious diseases were so important that the Baganda, one of the pre-colonial nations of Uganda, incorporated them into the stories that interpret the origin of their people. In this account, diseases are represented in Walumbe, the brother of the first woman to inhabit the earth. Anger transformed him into a child murderer. Efforts to catch him did not work because his victims, instead of hiding in their homes, grazed with the animals or tended the gardens. Then, Walumbe's sister —Numbi—, her husband —Kintu— and their descendants became nomads, establishing settlements throughout the region. When these communities grew so large that they caught Walumbe's attention, a good part of the population had to flee. This parable, transmitted orally from generation to generation to the present day, shows that the Baganda knew the usefulness of "personal distancing" long before the arrival of the European colonists.
Recognizing the knowledge of native doctors or writing in African languages can be acts of resistance
The peoples of East Africa have overcome numerous infectious diseases. But often, elites ignore these experiences and insights.
In the colonial period, using the knowledge that Bifumbo learned from his grandfather was a crime. The British banned native medicine in 1957, a decision that was repeated in many African colonies. To remove the autonomy of African peoples and forcefully introduce them into Western economic models, Europeans understood that they must first weaken their cultures. The people of Africa, orphaned by social structures with which to defend themselves, would have no choice but to accept foreign domination. "The colonial system aimed to destroy all native forms of life, from the abstract to the material," says Ugandan writer Bwesigye Bwa Mwesigire. "The settlers outlawed or put a lot of effort into discrediting traditional medicine, languages, politics, architecture, or the religions of the peoples of Africa."
Bifumbo remembers that, during the colonial period, "the white churches said that our traditional medicine was diabolical." In the rugged mountains of southwest Uganda, a remote, isolated, roadless region, he found a safe haven to continue treating his patients.
The days when Bifumbo had to hide from the authorities are over. But the shadow of colonialism still obscures his work. Often their methods are despised. Outside of rural areas, many consider them primitive. As in the colonial period, teachers punish students who speak native languages instead of English, religious leaders invite Ugandans to reject the beliefs of their ancestors, and history classes hardly name the social and political structures of the peoples of Africa before the European invasions. Therefore, recognizing the knowledge of native doctors or writing in African languages can be acts of resistance.
Incorporate cultures into health responses
Uganda is, according to the Harvard University Economic Research Institute, the most culturally densely populated country in the world. So far, the authorities have recognized 45 languages and 65 different ethnic groups in a territory with more or less half of the surface of Spain.
The Joint United Nations Program on HIV / AIDS (UNAIDS) recognized the importance of this cultural wealth in halting the progress of HIV. UNAIDS collaborates with traditional Ugandan doctors to advise people living with HIV on how they should take their medicines and to disseminate health advice, especially in rural areas, that hinders the spread of the virus. According to the CCFU, the Ugandan government could use similar methods to stop the coronavirus pandemic.
UNAIDS recognized the importance of cultural wealth to halt the progress of HIV and collaborates with traditional doctors
In Africa, confinements or other measures to combat covid-19 have collided with a lack of trust in institutions, especially in the most impoverished neighborhoods or in rural regions, where states do not guarantee even the people social services. more basic. According to an independent survey, a third of the citizens of the Democratic Republic of the Congo disapprove of the rules to contain the pandemic. To prevent this rejection, the CCFU proposes to adapt the responses to the social context of each region, in addition to collaborating with cultural leaders.
"Public health norms take better root in local contexts when they recognize their cultures and take into account their previous experiences with similar scenarios," says Musasizi. “It is necessary that the authorities recognize and stimulate cultural initiatives to fight epidemics, not only through research, documentation or publicity, but also with the integration of our cultural resources in response strategies. This can help us both to fight covid-19 and with other epidemics in the future. "
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