By Prof. Anneke Zuyderduin, RN PhD and Prof. Abel Pienaar, RN PhD
Training African nurses under the educational model in the Western biomedical tradition has resulted in a loss of connection with indigenous knowledge systems, as well as undervaluing the merits of intuition and the spiritual paradigm. For example, marginalized indigenous populations such as the KhoiSan in South Africa require access to the “veld” to gather traditional foods and medicinal plants. Notably, they also confirm the importance of values of sharing and trading that are at the heart of land care and food sovereignty. For indigenous peoples, land and food are at the center of what it means to be indigenous, hence they consider and foreground the sacredness of lands, foods, medicines, and animals, not just its use and exploitation.
With regards to food safety, the undervaluing of indigenous food practices is easily observed. This is in spite of the fact that indigenous knowledge has been accumulated over thousands of years, making it particularly essential for food safety problem solving. Communities have vetted solutions and knowledge systems over time, retaining only the efficacious ones. This model of knowing, seeing, and thinking is passed down orally from generation to generation, reflecting thousands of years of experimentation and innovation in topics like agriculture, animal husbandry, child rearing practices, educational systems, medicine, and natural resource management—among many other categories. Yet, few African health professionals learned about this during their training, and textbooks are few and far between.
These systems of knowledge are particularly important in the era of globalization, against which indigenous knowledge as intellectual property is taking new significance in the search for answers to many of the world’s most vexing problems such as: disease, famine, ethnic conflict, and poverty. Indigenous knowledge has value, not only for the culture in which it develops, but also for scientists and planners seeking solutions to community problems at large.
Cumulative injustices caused by ignoring indigenous knowledge systems and health practices need to be faced and redressed if nursing practice is to be relevant in the era of globalization. Nursing has a key facilitative role to play in promoting comprehensive care, and it can provide meaning for patients through encouraging the harmonization and co-existence of Western and African indigenous health knowledge systems.
With due cognizance to postcolonial dynamics, nurses need to revisit why they are comfortably undermining the indigenous health system which has stood the test of time, even under oppression in Africa. Secondly, the dominant Western health care system controversies are well documented, yet nurses largely remain silent. Anecdotal evidence explains this — nurses would say they are embarrassed to talk about their traditional practices, so they would rather keep quiet.
Based in South Africa, SEBOKA is a platform where African health professionals reconnect with authentic culturally aligned nursing research and practice. The strength of SEBOKA’s health system interventions center on a refusal to unconsciously “download” and apply methods that work in the global north. Instead, we repeatedly show how in reality, in African settings where 80% of health care users consult with indigenous healers, health providers in the clinic/hospital settings often do not comprehend indigenous healing. Sadly, they choose to ignore it, or worse still, they ridicule patients by shaming them for their ‘‘ignorance.’’
Can African caregivers share the originality of who they are if they are ashamed of talking about their own health beliefs? If caregivers cannot acknowledge that as Africans they embrace both indigenous health practices as well as Western health care, how can they provide holistic care as they themselves are fractured?
It is time to decolonize nursing and acknowledge the merits of the courage to stop being ashamed of non-Western health practices and beliefs that protect the earth. This will allow health professionals self-affirmation, the ability to act ethically and creatively, the ability to effect change, the strength to face challenges, and the aptitude to motivate others by being role models.
Nurses can play an important role in promoting social justice and advocating time tested local and sustainable solutions that comprehensively address nutritional, medicinal and spiritual needs. Mother Earth is not a resource but a source of life itself.