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BACKGROUND: Pakistani immigrants are the largest non-Western ethnic minority group in Norway. Traditional medicines (TM) are extensively used in Pakistan, and studies show that ethnic minorities also use them to recover from illness after migration to the Western world. This study aims to explore Pakistani immigrants' experiences and perceptions of risk regarding the use of TM to treat illnesses. METHODS: A qualitative study was conducted through in-depth interviews (n = 24) with Pakistani immigrants in Norway from February to March 2023. Participants were recruited through purposive and snowball sampling methods. The data was analyzed using Braun & Clarke's reflexive thematic analysis (RTA) using Nvivo. RESULTS: RTA revealed three main themes and six sub-themes. The main themes were: (a) House of knowledge, (b) Choosing the best possible approach for health restoration, and (c) Adverse effects of TM used. A total of 96 different TM were identified, including herbs, food items, animal products, minerals, herbal products, and ritual remedies. All participants used TM to restore health in acute and chronic diseases, and many used TM along with conventional medicines. The participants' mothers were the primary source of knowledge about TM, and they passed it on to the next generation. They also frequently used religious knowledge to recover from illness. Although TM is considered safe because of its natural origin, some participants experienced adverse effects of TM, but none of them reported it to the health authorities. CONCLUSION: The study helps to understand the experiences and perceptions of risk of Pakistani immigrants in Norway regarding traditional practices for treating health complaints. Public health policies to improve the health of these immigrants should consider the importance of TM in their lives. Further research is necessary to explore the safety and toxicity of those TM that are common in Pakistani households in Norway.

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The editorial highlights the fact that there is limited communication between healthcare providers and patients about complementary and integrative medicine (TCI) like Ayurveda. To address this, healthcare professionals need better education on Ayurveda. Additionally, international collaborations can enhance research and credible information, ensuring safe and effective patient care.

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This research investigates the complex dynamics of Uganda's recent Ebola outbreaks, emphasizing the interplay between disease spread, misinformation, and existing societal vulnerabilities. Highlighting poverty as a core element, it delves into how socioeconomic factors exacerbate health crises. The study scrutinizes the role of political economy, medical pluralism, health systems, and informal networks in spreading misinformation, further complicating response efforts. Through a comprehensive analysis, this study aims to shed light on the multifaceted challenges faced in combating epidemics in resource-limited settings. It calls for integrated strategies that address not only the biological aspects of the disease but also the socioeconomic and informational ecosystems that influence public health outcomes. This perspective research contributes to a better understanding of how poverty, medical pluralism, political economy, misinformation, and health emergencies intersect, offering insights for future preparedness and response initiatives.

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BACKGROUND: The concept of 'medical pluralism' has become more popular among scholars in applied health science and prevalent in societies where one medical system alone cannot adequately meet the health care needs of the entire population. METHODS: The data collection is focused on the knowledge-belief-practice and the utilization of three medical systems in Kabupaten Bandung, West Java, Indonesia. Participants were purposively selected from households with at least one member experienced one of the listed diseases in the questionnaire. The extensive survey using a structured questionnaire has been undertaken to collect data on people's health care utilization behaviour. The dataset is further analyzed using multivariate analysis through non-canonical correlation, with the analytical data provided by Statistical Package for Social Sciences (SPSS). RESULTS: With regards to the total utilization by patients, the traditional medical system presents as the dominant medical system in the research area, accounting for 59.3% (n = 419) of total utilization, followed by the modern medical system (33.0%, n = 233), and transitional medical system (7.7%, n = 54). This study identified that village category, illness, illness duration, occupation, belief in traditional medicine, knowledge of modern medicine, accessibility, cost, proximity to the medical service, and insurance have significant (χ2 = 0.000) relationship with the utilization of medical systems. The results of the multivariate analysis show that the block of the predisposing socio-demographic factors and the block of the predisposing psycho-social factors correlate strongly with the utilization of medical systems. CONCLUSIONS: In general, people in Kabupaten Bandung, West Java, Indonesia seeks treatment from various sources, which in the context of the medical system, consists of the traditional, transitional, and modern medical system; therefore, it adopts the patterns of transcultural health care utilization. In terms of the knowledge, beliefs, and practices of traditional medicine in West Java, the inhabitants of the five research villages were commonly familiar with medicinal plants and speak profoundly about their knowledge of traditional medicine, which in the research area is perceived as accessible, efficacious, affordable and culturally appropriate with Sundanese community.

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Culture, health, and medicine intersect in various ways-and not always without friction. This paper examines how liberal multicultural states ought to interact with diverse communities which hold different health-related or medical beliefs and practices. The debate is fierce within the fields of medicine and bioethics as to how traditional medicines ought to be regarded. What this debate often misses is the relationship that medical traditions have with cultural identity and the value that these traditions can have beyond the confines of the clinical setting. This paper will attempt to bring some clarity to the discussion. In so doing, it will delve into some controversial areas: (1) the debate around whether liberal states ought to embrace multiculturalism, (2) the existence and nature of group-differentiated rights, (3) the question of whether healthcare systems ought to embrace medical pluralism, and (4) what this would entail for policymakers, clinicians, and patients. Ultimately, I argue that liberal democratic states with multicultural populations ought to recognize medical pluralism as a matter of respecting group-differentiated and individual human rights.

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Rather than confining the categories health and sickness to a biomedical conception of the biological organism, there is growing recognition of epistemological and ontological multiplicity in the realm of diagnosis and, indeed, in the very realm of disease itself. In short, the empirical manifestations of health and illness as well as the processes thought to cause them are now understood to assume a much wider variety of both biological and other forms. This essay considers the underlying epistemological and ontological opportunities and challenges of taking what we are calling this diffusion of diagnosis seriously. By diffusion we mean the movement from a concentrated understanding of diagnostic authority as confined to scientific biomedicine to a less concentrated appreciation of the diverse approaches to diagnosis throughout the world. We consider the extent to which, and the manner in which, we as sociologists of diagnosis might not only critique these various processes but perhaps also take them seriously in an ethnographic sense as locally produced, evaluated and legitimated forms of health care.

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Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted with 18 THPs in Johannesburg, South Africa between January and May, 2022. Interviews were transcribed and translated into English. Data were managed using NVivo 12 software and thematically analyzed. The majority of THPs interviewed indicated that initiation as a THP was almost always preceded by a sickness accompanied by dreams/visions that represented an "ancestral calling" to become a healer. Most THPs also trained as both sangomas-who healed according to traditional beliefs-and prophets-who healed according to Christian beliefs. This reflects a syncretic relationship between traditional African beliefs and Christianity. However, not all churches are accepting of traditional beliefs and subsequently these THPs are members only at non-Pentecostal AIC churches who blend both African and Christian practices. Similar to these forms of religious pluralism melding Christianity and traditional beliefs, many THPs also often practice medical pluralism, mixing Western treatments with traditional practices/medicines. THPs are able to adapt elements of Western and African beliefs into healing practices that span multiple religious and medical fields. Thus, collaborative and decentralized healthcare services may be highly acceptable among such a pluralistic community.

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PURPOSE: As cancers increase in Ghana and in many low-and middle-income countries, healthcare utilization has become critical for disease management and patients' wellbeing. There is evidence that medical pluralism is common among cancer patients in Ghana and many other African countries, which results in lack of adherence to and absconding from hospital treatments. The objective of this study was to examine ways in which beliefs in disease causation influence medical pluralism among Akan cancer patients in Ghana. METHODS: A qualitative research approach was employed in this study. In-depth interviews were conducted for thirty (30) cancer patients who were purposively recruited from Komfo Anokye Teaching Hospital in Ghana. Thematic content analysis was used in analysing data. RESULTS: Our findings revealed that cancer patients ascribed both physical and spiritual causality to their illness. As such, they combined orthodox treatment with spiritual healing and herbal medicine. Regarding the order of therapeutic search, patients reported to herbal and spiritual centres before going to the hospital, a phenomenon which contributes to the late reporting and diagnosis as well as bad prognosis of cancers in Ghana. CONCLUSION: The findings of this research elucidate the relationship between culture and health care choices of cancer patients in Ghana. Increased awareness creation is crucial in eradicating myths surrounding cancers in Ghana.

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This special issue brings together five original research papers on chronic conditions in South Asian contexts with a view to rethink dominant discourses of risk, evidence and control surrounding the category of chronic conditions. Focusing on the multiple and contradictory (re)definitions of what counts as illness, specifically in the context of the rising burden of chronic illness, the papers in this issue deal with a range of health care practices from individual patients negotiating with 'healthy diet', to policy questions about the etiology of emerging disease burden and appropriateness of pharmaceutical interventions in 'traditional' sites of healing. While some of the chronic illnesses addressed in this special issue have received considerable attention from anthropologists (e.g. mental illness, diabetes), others, like leucorrhea have rarely been studied by anthropologists, despite the growing literature on 'chronic illnesses'.

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Men are less vulnerable to HIV acquisition than women, but have poorer HIV-related health outcomes. They access HIV services less, and are more likely to die on antiretroviral therapy. The adolescent epidemic presents further challenges, and AIDS-related illness is the leading cause of death among adolescents in sub-Saharan Africa. We explored the health practices of adolescent boys and young men (aged 13-22) living with perinatally-acquired HIV and the processes through which these practices are formed and sustained. We engaged health-focused life history narratives (n = 35), semi-structured interviews (n = 32) and analysis of health facility files (n = 41), alongside semi-structured interviews with traditional and biomedical health practitioners (n = 14) in the Eastern Cape, South Africa. Participants did not access traditional products and services for HIV, a finding that deviates from much of the literature. Findings suggest that health practices are mediated not only by gender and culture, but also childhood experiences of growing up deeply embedded in the biomedical health system.

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The current global economic and biomedical perspectives contribute content, strategy, and values to global health systems, like objectification and competition, which encourage the medicalisation of the system. Medicalisation overlooks our interdependence with other beings, the environment and biosphere. In contrast, ancient health traditions like Ayurveda, derived from Asian cultures, provide knowledge of the human being's composition of five basic states of nature that need to remain in constant equilibrium to ensure health (Svasthya). Asian health traditions encourage values like vulnerability and respect to facilitate an inherent relationship with the internal and external environment. The recent pandemic has revealed the fragile vulnerability in this nexus and the consequences to human health and well-being when that equilibrium is disturbed. Serious deliberations and discussions are needed between the modern economic and the Asian frameworks for healthcare which result in two different approaches to health and to health systems. This debate may encourage the creation of a philosophy and structure for a new global pluralistic health system more aligned to nature. These deliberations need to encourage the discussion of Svasthya (health), Soukhya (sustainable happiness), and the inner and outer ecological landscapes experienced by human beings that can be understood through mindful self-awareness. Global health systems need to evolve in the direction of a different, pluralistic philosophy of health that encourages a 'population's self-reliance in health' through an intimate and integrated connection with nature.

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Under the aegis of the World Health Organization, the Movement for Global Mental Health and an Indian Supreme Court ruling, biomedical psychiatric interventions have expanded in India augmenting biomedical hegemony in a place that is known for its variety of healing modalities. This occurs despite the fact that studies by the WHO show better outcomes in India for people suffering from schizophrenia and related diagnoses when compared to people in developed countries with greater access to biomedical psychiatry. Practitioners of ayurvedic medicine in Kerala have been mounting a claim for a significant role in public mental health in the face of this growing hegemony.This study examines efforts by ayurvedic practitioners to expand access to ayurvedic mental health services in Kerala, and profiles a rehabilitation center which combines biomedical and ayurvedic therapies and has been a key player in efforts to expand the use of Ayurveda for mental health. The paper argues for maintaining a pluralistic healing environment for treating mental illness rather than displacing other healing modalities in favor of a biomedical psychiatric approach.

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This work presents a neo-Gramscian theorization of therapeutic hegemony and subalternity, deployed with reference to the practice of homeopathy in North America by two increasingly-professionalized but unorthodox health occupational groups: Homeopaths and Naturopaths. Despite both occupations' contemporary sociopolitical subordination to dominant biomedicine, the continent's Homeopaths have been less successful in their professionalization efforts, owing partly to homeopathy-their primary therapeutic modality-being widely considered incommensurable with biomedical science. For Naturopaths, who increasingly align themselves with biomedical evidentiary norms, homeopathy represents but one among several central therapeutic modalities. Using survey (n = 588) and interview (n = 31) data from an empirical case involving Homeopaths and Naturopaths in Ontario, Canada-a jurisdictional outlier in which both groups are regulated by the state-the author employs the theory of therapeutic subalternity to illuminate the internal struggles faced by homeopathy-practising occupations in a biomedically-dominant context. Despite their regulated standing, Homeopaths' negative media characterization and ongoing lack of access to third-party insurance reimbursement contribute to ongoing frustration among practitioners, expressed as displaced envy toward the province's more elite, homeopathy-practising Naturopaths. However, while most Naturopaths express appreciation for homeopathy's clinical merits, many appear increasingly reluctant to use or discuss the practice to prevent compromise to their profession's therapeutic legitimation.

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This essay provides an overview of the contributions by Emily Baum, Chengyang Jiang, and Sandra Teresa Hyde. Chinese history and culture provide a useful resource for thinking beyond the limits of the contemporary human sciences, such as the way that the mind operates as a contested object of knowledge across time, place, and disciplines.

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The movement for global mental health (GMH) has brought perennial questions about human diversity in mental health to the fore through heightened debates over if and how established knowledge, institutions, and practices should be altered for ethical and effective interventions with diverse peoples around the world. Kirmayer and Pedersen (2014) encouraged dialogue between GMH scholars and communities considered for intervention to address differences and concerns about colonialism. American Indian mental health offers an instructive site for global mental health inquiry to understand frameworks that might facilitate this desired dialogue. Here, we draw from a clinical ethnography in urban American Indian behavioral health conducted between September 2014 and February 2015 to glean insights into a popular response to these differences: Incorporating Indigenous cultural forms into clinical practice. Our findings highlight a predicament this response presents to mental health professionals. They can either eschew their clinical training and its cultural assumptions to take up new lives enabling their representation of Indigenous cultural forms, or they can hold onto their professional training and modify what is clinically familiar to appear culturally different. Rather than a purposeful decision, in the clinic contextual factors-tacit assumptions, clinic structures, and popular culture concepts-powerfully shaped clinical practice and reconfigured Indigenous cultural forms to support familiar clinical processes (e.g., treatment-planning). Although potentially therapeutic, culturally repackaged mental health practices are not the therapeutic alternatives called for by many Indigenous communities, and when advertised as such, risk harmful appropriations and misleading reticent people into participating in culturally prescriptive interventions. Lessons for global mental health point away from incorporating Indigenous cultural forms into clinical practice, which is likely to result in cultural repackaging, toward ethnographically-informed dialogue of differences to inform models for medical and epistemic pluralism providing interested communities more culturally commensurate mental health services alongside well-supported Indigenous therapeutic alternatives.

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HIV and emotional distress often co-occur and interact in syndemic clusters with social, political, and economic factors that amplify the 'syndemic suffering' of individuals. In this paper, I describe how HIV+ women seeking antiretroviral therapy (ART) at a hospital in northern Tanzania engaged with plural methods of healing to ease suffering and address the multiple dimensions of illness. I explain the case of a famous faith healer at the time of research from 2011-12, 'Babu wa Loliondo,' from whom a third of the women interviewed - 25 of 75 - sought care in addition to their ART. These women experienced significantly fewer symptoms of emotional distress compared with those women who did not, suggesting that either those who sought his care were already healthier, or one strategy for coping - engagement with medical pluralism - played a role in buffering against syndemic HIV and emotional distress.

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This study examined whether the frequency of participation in religious activities and seeking care from spiritual and other traditional medicine (TM) practitioners were associated with blood glucose (HbA1c) control among urban Ghanaians with type 2 diabetes mellitus (T2DM). Findings revealed that increased frequency of participation in religious activities was significantly associated with decreased HbA1c levels, whereas increased use of TM practitioners was significantly associated with increased HbA1c levels. These findings suggest that strategically integrating religious activities into disease management plans for Ghanaians with T2DM who identify as being religious may be a viable intervention mechanism.

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Whilst quarantine has been experienced in a multitude of ways around the world, for some anthropologists the quietening of public movement was met with a flurry of attentive typing. For those who were consciously quarantined, a social science response to COVID-19 was sought at University College London through a call for posts as part of the UCL Medical Anthropology blog; capturing the real-time observations and scholarly reflections on the unfolding pandemic situation as it reached its height across the globe. The global flow of coronavirus - both as a literal microbial agent and as an idea - has played out on the 'coronascape' in multiple ways since it exploded onto worldwide consciousness in early 2020. From an anthropological perspective, concerns have oscillated around a number of crucial themes, from (micro)biopolitics, governance, and sovereignty; the defence of borders from foreign bodies and post-colonial Others; a strengthening of medical pluralism and the global biomedical hegemony, and concerns over where to go from here as second-waves and the social consequences of such loom large. Such themes have often interrelated and tangoed with one another as individuals have reflected upon their significance. In this review we provide a critical overview of the first fifty-seven posts that were sent to the blog in the initial months of the pandemic; with contributors exploring the developing pandemic in over twenty countries, and with posts visited daily by over two thousand visitors from across the world during the months of the UK lockdown (March-May).

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This article discusses the interlinkage of medicine and the miraculous in the healing actions of living saints, based on the canonisation dossiers of St Francesca Romana (1440-53) and St Francesco di Paola (1512-17). These documents include a large number of miracles performed by saints during their lifetime, and in a large proportion of these cases, the holy person administered some kind of medical substance to an infirm devotee before or while performing the miracle. While the commissioners of canonisation inquests had to determine that the cure was of a miraculous origin, it appears that for the devotees the medical and miraculous acts were an inseparable part of the same continuum. Occasional conflicts arose with medical professionals, but the living saints also collaborated with them. The connection of a medicating saint and a miracle-performing saint is thus an essential aspect of the medical pluralism of late medieval and early modern societies.

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The Truth and Reconciliation Commission of Canada made it clear that understanding the historical, social, cultural, and political landscape that shapes the relationships between Indigenous peoples and social institutions, including the health care system, is crucial to achieving social justice. How to translate this recognition into more equitable health policy and practice remains a challenge. In particular, there is limited understanding of ways to respond to situations in which conventional practices mandated by the state and regulated by its legal apparatus come into direct conflict with the values and autonomy of Indigenous individuals, communities, and nations. In this paper, we consider two cases of conflict between Indigenous and biomedical perspectives to clarify some of the competing values. We argue for the importance of person- and people-centered approaches to health care. These value conflicts must be understood at multiple levels to clarify their personal, social, cultural, and political dimensions. Taking into account the divergence between epistemic cultures and communities allows us to understand the multiple narratives deployed in decision-making processes in clinical, community, and juridical contexts. Recognizing the knowledge claims of Indigenous peoples in health care can help clinicians avoid reinforcing the divides created by the structural and institutional legacy of colonialism. This analysis also provides ways to adjudicate conflicts in health care decision-making by disentangling cultural, political, medical, and pragmatic issues to allow for respectful dialogue. Insofar as the engagement with cultural pluralism in health care rights is conducted with reciprocal recognition, the medical community and Indigenous peoples can address together the difficult question of how to integrate different epistemic cultures in the health care system.

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