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Combining Western and Traditional Methods to Treat Mental Illnesses

At the beginning of October, 33-year-old Dume, who prefers to use his middle name only, believed he had been bewitched. He didn’t feel like himself. Thoughts were racing through his head and he kept hearing someone call out his name although no one was around. Terrified by how confused their son had become, Dume’s parents called a traditional healer in their village in eastern Unguja, the main island in the Zanzibar archipelago. When Dini Uwezu Makame arrived to treat Dume, he immediately knew something was very wrong. But instead of attempting to exorcize an evil spirit, or a jinn, or remove a curse — widely believed to be the cause of mental illness in Zanzibar — Makame referred Dume to the district hospital, where he received antipsychotic medication. The 29-year-old traditional healer, or mganga in Kiswahili, is part of a new movement of healers who are collaborating with mainstream medical practitioners to reduce the mental health treatment gap in the semiautonomous archipelago. While healers often use remedies such as powdered roots, saffron-inked scriptures dissolved in water or incantations to treat mental health conditions, they are increasingly becoming the link to modern mental health services. Since 2017, the U.K. charity Health Improvement Project Zanzibar (HIPZ) has trained nearly 50 traditional healers in how to detect signs of mental illness and provide basic problem-solving therapy, as well as how to refer severe cases to Zanzibar’s clinics or its psychiatric hospital. Over the past three years, district hospitals and primary health care units have seen a growing number of reported psychiatric cases, from 64 per year to 164.