Understanding the influence of spiritual beliefs on epilepsy care
In Uganda, a person who suffers the repeated seizures associated with epilepsy is most likely to seek help first from a traditional or spiritual healer, which may not be surprising considering that two-thirds of Ugandans say they believe seizures may be caused by spiritual influences, such as ancestral determinism, witchcraft, or demonic possession.
But belief is not the only reason many Ugandans rely on healers. In a country with one medical provider for every 20,000 residents, there are by some estimates 100 times as many traditional and spiritual healers, offering an around-the-corner convenience an under-resourced health system like Uganda’s can’t hope to match.
“They are far more accessible for those in a community who can’t necessarily get to a clinic, and certainly not to a regional or national hospital,” says Deborah Koltai, an associate professor of psychiatry and behavioral sciences, neurology, and neurosurgery whose team recently completed one of the first countrywide surveys of Ugandans’ attitudes about epilepsy. “For a very large proportion of the population, (traditional and spiritual healers) are considered and consulted as the experts on this disorder because they are believed to negotiate the intersection of physical and spiritual worlds.”
And that makes the role of healers a unique and challenging variable in Uganda’s efforts to address its growing burden of epilepsy, a chronic, but treatable disorder that frequently goes undiagnosed in low- and middle-income countries. Around 80 percent of people with epilepsy live in such settings, and it’s estimated that three-quarters of them – roughly 40 million people globally – don’t receive adequate care.