The culture of medicine: a South-African perspective

HERBAL MEDICATION

- DR ISHQ PRAMCHAND

“AMPUTATE my leg? Doctor, what do you mean?”

A conversation can be lifesaving. A doctor's decision to treat is complex, influenced by myriad factors, extending beyond the physical health of the patient.

Some elements of health, however, go under-recognised and underappreciated in a holistic evaluation by medical practitioners, undermining optimal patient management.

A failure to consider the significance of culture and deep-rooted tradition in medical decision-making may have dire consequences, with the potential of incurring patient harm and even death.

South Africa is a diverse population, home to 12 official languages. Where English is the lingua franca, medical practitioners in urban and rural settings are also exposed to a vast proportion of patients with poor proficiencies in English.

Personally, the abundance of clinical exposure to rural communities during my student years has taught me that a good working knowledge of medical isiZulu is necessary to engage effectively with patients at a grassroots level.

Survival phrases in isiZulu such as “Sawubona mama... Unjani?” (Good morning mum. How are you?) or “Ngin-gakusiza ngani namhlanje?” (How may I assist you today?) are incredibly helpful to the young doctor who wishes to build therapeutic alliances with patients in local communities and explore local cultures.

Notwithstanding, there is always more to learn. My year in community service where I served as a medical officer in surgery further revealed the vital roles that traditional healers and non-allopathic forms of medicine play in the comprehensive assessment of the surgical patient in a local setting.