title: Reconsidering the allure of the culturally distant in therapy seeking: a case study from coastal Tanzania.
abstract: This article examines two seemingly contradictory notions found in the anthropological literature that address so-called traditional healers. First, it suggests that despite their purportedly holistic approach, healers in coastal Tanzania may not be as popularly sought after by "local" people as they are made out to be by some academics and health policy researchers. Second, it contends that although there may be a tendency among the people of Tanzania to consult "distant" healers for social relationship-related conditions, the decision-making process involved in seeking out such healers is far more dynamic and context dependent than has been previously reported in the literature. People who seek help from distant healers have often unsuccessfully tried locally available health care resources. In making these arguments, I draw on ethnographic data gathered in a large village in the Dar es Salaam region of coastal Tanzania. In particular, I examine the divinatory practices of a well-known Zaramo healer (mganga) and discuss narrative case studies of two patients who had traveled from distant places to seek the mganga's help. The article concludes with a call for the critical reevaluation of propositions for the integration of "traditional healers" in programs aimed at the prevention and treatment of life-threatening infectious diseases that are predicated mainly on the assumption that healers are popular among the local people and provide effective consultations.
authors.affiliation: Department of Anthropology, University of British Columbia, Vancouver, British Columbia, Canada. kamatvin@interchange.ubc.ca
authors.forename: Vinay R
authors.initials: VR
authors.lastname: Kamat
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D001294:Attitude to Health / Q000208:ethnology*; D003657:Decision Making; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016488:Medicine, African Traditional; D008875:Middle Aged; D013636:Tanzania