By Dr Tafataona Mahoso

TINA is an abbreviation for the slogan ‘There is no alternative’, which many credit to the late former UK Prime Minister Margaret Thatcher. 

The context of Thatcher’s declaration was her belief and assertion that ‘There is no alternative’ to neo-liberal economics and ne-oliberal reforms.

Underlying the crisis of Western-oriented science and medicine is the fact that they are founded on the linear assumption that ‘There is no alternative’, which explains why Michael Gelfand’s book on the history of missionary sponsored medicine in Zimbabwe had to be titled Godly Medicine while Church Missionary Society’s doctor to Tanganyika Paul White called the book about his stint in Tanzania Doctor of Tanganyika, first published in 1941.  

He was the ‘doctor’ of all of Tanganyika!

The image of the white medical doctor in Africa depicted through these books was that of a warrior, an adversary against disease and presumed superstition, ignorance, heathen practices and demonic forces.  

This worldview was understandable, given the origins of Eurocentric medical practice as an appendage of the Roman Catholic Church in which the pioneer medical professors were no match for the healing powers and wholistic practices of community-based European women healers. 

The professors had to use the political and spiritual powers of the organised church to launch a continental witch-hunt which resulted in the Great Inquisition and witch-craze in which the women were condemned as servants of the devil; tortured and burned alive as witches!

Another characteristic of this patriarchal medical system has been its over-emphasis on cure rather than prevention and environment, its substitution and promotion of the controlled ‘hygienic’ enclosures of the exclusive hospital over preventive care and the ecological and wholistic environment of society and the economy.  

This emphasis means that drugs, theaters and tools with which to carry out emergency operations tend to be exaggerated at the expense of prevention and the creation and maintenance of a healthy society and healthy families.

What is encouraging, however, is that the global movement giving rise to demands for a circular economy and circular economics is also giving rise to the recognition of relational science and relational medicine.

These movements constitute a global homecoming to the underlying philosophy of the African dariro, the elemental prototype of the circular economy where the potential adversary or opponent is removed from an ‘us versus them’ dichotomy to become a provider of alternatives.  

This happens because people sitting in the dariro always leave space or ground in the middle which represents the ecological and communal interest of all:

• Joining the dariro is already a silent expression of willingness to sing or dance along; or willingness to learn to sing and dance along; or willingness to speak the language spoken in the dariro; or willingness to learn and understand that language.

• When there are more people, the circle is widened, but it remains a circle.

• At the level of the community or neighbourhood, the circle teaches that the harm inflicted on your neighbour’s child in that dariro is quite capable of being inflicted on your own child sitting in that same circle; the harm inflicted on your neighbour’s mother sitting in that dariro of mothers will sooner rather than later hit your mother, aunt or sister occupying the same space in that circle.

• Therefore, you watch what may come from behind my back, while I watch what may come from behind you. If I face you from the south I see the north which is your back and you see the south which is my back. If I face you from the east, I see the west which is your back and you see the east which is my back. In this way, the African worldview has always been global; memory is global.

In Man Cures, God Heals, Kofi Appiah-Kubi cited the Akan healer and medical practitioner Nana Afua Nsiah who expressed the African relational view of health service as follows:

“Who am I to prevent anybody from serving our great God?  

You see, Mister, these people (coming to seek her services) have left their cathedrals and huge (Western-oriented) hospitals for my humble abode, they should therefore be provided for.  

After all, we are all children of God.   

Moreover, I firmly believe that there are some simple ailments that can be better cured at the hospitals or clinics with the ‘whiteman’s’ medicine.  

No, not at all, they do not show (or present) any threat to my profession.  

If only they themselves are not threatened by me.  

In fact, I personally believe in co-operation, (with them).  You see everybody here, whether patient or otherwise, is part of the healing team or community.  

We must therefore co-operate during the healing ceremony.  Indeed I thrive on co-operation and communal action.”

Chapter 10 of Dr Paul White’s Doctor of Tanganyika is titled ‘Witchcraft and Native Medicine’. 

Reading that chapter, the reader realises that apart from the instrumentalist, modernist linearism built-into Western medical practice, one of the biggest barriers between Western and indigenous African practitioners were the miseducated and missionary converted Africans who did most of the interpretation work for the mission doctor.

When one Daudi brought White to a Tanzanian village where there was an African medicine man, he said to White:

“Go very quietly, Bwana, and leave the talking to me first… The old man with the hardware in his ears is a witch doctor, Bwana. 

He doesn’t like your being here.  

Let us talk of magic, and then you show some of your tricks.” 

The white doctor confesses to the reader that: “One of my schoolboy hobbies had been conjuring.”  

So he agreed to the suggestion that he should perform some of his common magic tricks from his school days in order to show that his science and his faith (God) were superior to African medicine and beliefs!

This approach was the exact opposite of what African philosophy teaches; what Nana Afua Nsiah of Ghana taught as an African medical practitioner and healer.  

That is why, in his book, Appiah Kubi wrote:

“Western trained doctors (and in this case, Christian converts) hope to see these (African healing) practices eradicated by modern (linear) science, especially in modern urban centres, but their persistence even where these centres (Western centres) are available is proof of the usefulness of the traditional services and their importance to the Akans.”

In the last instalment, I referred to the book Our Bodies, Ourselves by the Boston Women’s Health Book Collective. That book dedicated the entire Chapter 5 to ‘Health and Healing: Alternatives to Western Patriarchal Medical Health Care’.

The North American women wrote:

“Alternative or wholistic approaches to healing are based on certain underlying assumptions: first, that we are healthy when our body/mind/spirit exist in a dynamically balanced state of well-being.  

Though we are physically made up of cells, tissues, organs, etc, no parts of us can be understood as isolated entities; all (are) interconnected, they are harmoniously related.”

They proceeded to say: “Our interactions with our family, community and world affect and shape our health… We do need professional (medical) help with health problems, even when medical approaches are not always the best, with their excessive emphasis on drugs, surgery and crisis intervention.”

Feminist philosopher Professor Mary Daly (now late) took the analysis of linearist interventions and violence to a deeper level.

In her book Pure Lust: Elemental Feminist Philosophy, Professor Daly suggested that the Western patriarchal myth of effective intervention – whether in religion, military aggression, science or medicine – was and still is based upon a process linking together assault, annihilation, reconstruction and restoration, with restoration never actually succeeding in putting back the authentic original.

The book Our Bodies, Ourselves was also based on the palpable recognition among many women that, through its installation of the MD as a sort of dictator, Western medicine had persistently and continually refined that linear  process of assault, annihilation, reconstruction and restoration against the integrity of the female body and its quest for wholistic health.  

That is why this system continued to deploy and concentrate the bulk of health resources in instrumentalist cures and operations at the expense of other aspects of health.