On the creation and dissolution of ethnomedical systems in the medical ethnography of Africa

Abstract

AbstractBetween the mid-1970s and mid-1980s a number of publications appeared in which earlier ethnographies of illness and misfortune in Africa were criticised for placing too much emphasis on supernatural causation and neglecting natural causation and practical medical behaviour. Indeed, following Warren's (1974) first criticism of Field, there was what almost amounted to a crusade to prove that Africans traditionally recognised a separate medical domain in which they interpret illness primarily in empirical and practical rather than in social and moral terms.This article criticises the attempt to cast African aetiologies in a new light. Proceeding from a discussion of the distinction between naturalistic and personalistic aetiologies, around which the whole issue revolves, it examines the critics' claim that ethnographers have placed too much emphasis on supernatural causation in African aetiologies, that once these aetiologies are viewed more broadly they can in fact be seen to be largely naturalistic, and that one of the reasons for this bias is that earlier ethnographies, in particular Evans-Pritchard'sWitchcraft, Oracles and Magic, have been wrongly interpreted. A discussion of Evans-Pritchard's own description of Zande aetiology leads to the conclusion that the recent reinterpretations of Zande aetiology are mistaken. This raises the question: why the sudden desire to delineate discrete medical systems, and why so much emphasis on natural causation and practical activity?Following a discussion of Wimbum aetiology and the concept of medicine, based on fieldwork in the Grassfields of Cameroon, the author argues that the emphasis on naturalistic causation and practical activity in the definition of African medical systems does not make them broader, as the protagonists claim, but narrower, and that the ‘broader’ descriptions of medical systems are not more accurate representations of how Africans interpret and cope with illness but biomedically determined constructs imposed on African culture through medical ethnography. The article concludes with a plea for the dissolution of the concept of ‘ethnomedical systems’.