Holy water and biomedicine: a descriptive study of active collaboration between religious traditional healers and biomedical psychiatry in Ethiopia
Yonas Baheretibeb, Dawit Wondimagegn, Samuel Law
BJPsych Open March 9, 2023 Peer reviewed DOI: 10.1192/bjo.2021.56 via DOAJ
Summary
A collaboration between religious healers and psychiatrists in Addis Ababa, Ethiopia, proved feasible over eight years. Among 1,888 patients, 54% were first-time users of biomedical services, and 26% were referred by priest healers. Most had severe mental illness: 40% schizophrenia, 24% substance misuse, and 30% mood disorders. Over 92% were comfortable receiving holy water and prayers alongside medication, and 73.6% attributed their illness to evil spirit possession. The model may help scale up mental healthcare in resource-limited settings.
Study at a glance
| Design | case study |
|---|---|
| Sample size | 1,888 |
| Population | patients receiving holy water treatment and attending a collaborative psychiatric clinic in Addis Ababa, Ethiopia |
| Key finding | A cross-system collaborative model between religious healers and psychiatrists is feasible and can engage patients with severe mental illness who have not previously used biomedical services. |
Abstract
Background Religious and traditional healers remain the main providers of mental healthcare in much of Africa. Collaboration between biomedical and traditional treatment modalities is an underutilised approach, with potential to scale up mental healthcare. Aims To report the process and feasibility of establishing a collaboration between religious healers and psychiatrists in Addis Ababa, Ethiopia. To gain insight into the collaboration through studies of patient demographics, help-seeking patterns, nature of illness and receptivity of the project. Method This case study describes the process and challenges in establishing a collaborative psychiatric clinic for patients who are simultaneously receiving treatment with holy water, including an examination of basic clinical records of 1888 patients over a 7-year period. Results The collaboration is feasible and has been successfully implemented for 8 years. A majority (54%) of the clinic's patients were seeing biomedical services for the first time. Patients were brought in largely by families (54%); 26% were referred directly by priest healers. Most patients had severe mental illness, including schizophrenia (40%), substance misuse (24%) and mood disorders (30%). A vast majority (92.2%) of patients reported comfort in receiving treatment with holy water and prayers simultaneously with medication, and 73.6% believed their illness was caused by evil spirit possession. Conclusions A cross-system collaborative model is a feasible and potentially valuable model to address biomedical resource limitations. Provider collaboration and mutual learning are ultimately beneficial to patients with severe mental illness. Open-minded acceptance of cultural benefits and strengths of traditional healing is a prerequisite. Further study on outcomes and implementation are warranted.