Some cultural aspwcts of ethnomedicine, ethnoreligion, and gender in Zimbabwe

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Author: Takawira Kazembe

Introduction

The relationship of ethnoreligion and ethnomedicine may be viewed as synergistic, but ideally the nature of ethnomedicine in Zimbabwe demands that it be under the influence and control of ethnoreligion. Many people in Zimbabwe, the youth in particular, appear to be unclear as regards the strengths and weaknesses of ethnomedicine, criticizing it as unhygienic and lacking in efficacy, mainly due to socialization by colonial governments and missionaries (Peresuh et al. 1999). Whilst the missionaries and the colonial masters played havoc on the masses, the spirit mediums remained the custodians of the peoples' culture (Unpublished observation 2005). Large numbers of African families (both rural and urban) consult ethnomedical practitioners for their health care needs because these practitioners are accessible, affordable, culturally appropriate and acceptable. They explain illness in terms that are familiar because they are part of the local belief systems (Satima et al. 1998). The practitioner and the patient are culturally bound and the practitioner has a personal interest and stake in the patient (Waane, S.A.C. 1990). Ethnomedicine is part of culture which itself is always getting modified with time (Sindiga, L. 1995) and all medicine is modern (Janzen, L. M. 1978). African ethnomedical systems define disease and illness within given social contexts (Sindiga, L. 1995). Thus disease and illness are intricately interwoven in the social status of the group concerned. In ethnomedical systems, disease and misfortune are regarded as having socio-religious foundations (Sindiga, L. 1995) and treatment processes must include discovering the deep-seated causes and ways of preventing recurrence.

The causes of disease and illness may be natural (God-given) or unnatural (human-induced) (Sindiga, L. 1995). Natural diseases such as diarrhoea, skin rash, and rheumatism may be treated by biomedicine or by ethnomedicine or by both (Sindiga, L. 1995). Human-induced illness may be a result of sorcery, witchcraft, spirit disturbances or breaching socio-religious obligations and taboos, especially with regard to the ancestors (Sindiga, L. 1995). Such diseases must be referred to ethnomedical practitioners with their various specializations: there are herbalists, diviners, seers, spiritualists, traditional surgeons and birth attendants (Sindiga, L. 1995). Unlike biomedicine which views disease and illness as physical or mechanical disorders with little or no relationship with a person's social or religious experience, thereby restricting treatment to controlling and eliminating physical symptoms, African ethnomedicine follows a holistic approach to medical situations, considering both organic and psychological attributes of disease and illness together, to come up with solutions (Sindiga, L. 1995). Africans move between biomedicine and ethnomedicine even for the same illness at the same time depending on what they perceive to be the source of the problem, using the two systems in a complementary or supplementary way (Sindiga, L. 1995). The theories and concepts of prevention, diagnosis, improvement and treatment of illness in ethnomedicine historically rely on holistic approach towards the sick individual, and disturbances are treated on the physical, emotional, mental, spiritual and environmental levels simultaneously. According to World Health Organization (2000) most systems of ethnomedicine may use herbal medicines or socio-religion based therapies along with certain behavioural rules promoting healthy diets and habits. Holism is a key element of all systems of ethnomedicine, so conventional efficacy assessment measures may not be adequate (WHO, 1993; 2000). Some ethnomedical practices even include the provision of the means for confession, atonement, restitution into the good graces of the family and tribe, and intercession with the world of the spirits (Ndeti, K. 1996). The training of biomedical practitioners involves an intensive and selective education, specializing in related medical disciplines. In contrast, African ethnomedical practitioners acquire their skills through observation and a long and tedious apprenticeship involving intervention of spirits and ethno-socio-curricula activities. Thus African ethnomedical practices are bound to be ethnocentric. The process in biomedicine is standardized and the products recognizable. In contrast, ethnomedicines are not easy to quantify and replicate. Their use necessarily involves trust in the healer (Waane, S.A.C. 1990).

The ethnomedical practitioner is often accused of being a jack of all trades and master of none, knowing everything about all diseases but nothing about any particular one, with no formal scientific training in modern medical science but following very primitive and backward practices (Ndeti, K. 1996). Some people consider the processing of ethnomedicines as unhygienic and unscientific because they are biased against the methods of grinding, pounding, chewing, boiling, etc. which in fact are just as hygienic and scientific as any used in industrial manufacturing. The use of such 'crude' methods may be dictated by the scale of operation and the physical and chemical characteristics of the plant raw materials themselves (Waane, S.A.C. 1990). Biomedical health care providers hold views on health that emphasize disease, focusing on the physical body in an attempt to be objective and scientific (Satma, et al. 1998). The administration of biomedicine is effected orally, by injection, or by topical application, etc., thus generally the same as ethnomedicine which also uses incisions and excisions in addition. In biomedicine, the medical practice and the doctor-patient relationship are very objective and impersonal, personal interest being aroused only when the patient or the manifestation of the disease is peculiar, abnormal, and therefore of scientific interest and the patient becomes a case (Waane, S.A.C. 1990). Ordinarily, biomedical personnel do not concern with the deep-seated causes of physical symptoms to disease. This is an area of ethnomedicine (Sindiga, L. 1995). Scientifically, biomedicine would do better and would advance its professional goal if it recognized the legitimacy of the ethnomedical approach to human healing since the beliefs of this approach figure very much in the inner reality of human life. They touch on many vital areas which are beyond the imagination of the present medical education and they are wholesome in approach (Ndeti, K. 1996). Research on ethnomedicinal plants is carried out to enrich biomedical practice.

The research would be more meaningful if it included the several cultural dimensions to supplement and complement biomedicine (Waane, S.A.C. 1990). The ethnomedical practitioner and the biomedical practitioner both share the physico-chemical approach to the treatment of disease, but the ethnomedical practitioner transcends the limits of the molecular approach into the powerful influences and interplay of an individual with his/her environment recognizing that human beings are constituted of psychic and physical realities which are distinct and not separate (Ndeti, K. 1996). Ethnomedical practices and their underlying beliefs are repositories of empirical observations and insights accumulated over long periods of practical experience. This wealth of information must be gleaned, articulated, and reinterpreted further by the newer experiences and knowledge, as more sophisticated analytical methods and technologies become available. With appropriate appreciation of the empirically identified maladies of the folklore, many of the ancient herbal cures have provided leads and have found rigorous scientific basis in the form of some modern medicines such as asprin, quinine, and rowalfine (Mahendra, K.-J and Alpils-Castro, R. 1993). Culturally people believe in the old while looking forward to the modern. It is therefore logical to incorporate use of ethnomedical dimensions in biomedicine, and vice versa, and establish a dialogue between them for the betterment of both practices and the community (Waane, S.A.C. 1990). This is successfully being done in Benin.

The barrier between biomedicine and ethnomedicine on the African continent might appear insurmountable but that is due to the way biomedicine was introduced to Africa by colonial governments. African ethnomedicine was suppressed and then ignored (Sindiga, L. 1995). In developed countries, a resurgence of interest in herbal medicines has resulted from the preference of many consumers for products of natural origin (WHO, 1996). The arsenal of biomedicine can no longer cope with the many different health problems and the medicines are less and less available (Van Puyvelde, L., 1996). Ethnomedicine can be developed on the same lines biomedicine has been developed. Consider the attempts made in Rwanda and Mali where researchers have directed their activities towards developing traditional medicine (Van Puyvelde, 1996; Diallo et al. 1996). Exploitation of African medicinal plants for commercial purposes is not new. Consider the aloe species which are native to East and Southern Africa. Their medicinal use in Africa is extensive and has been for thousands of years (Raina, M.K. 1982). They are described in pharmacopoeias and in traditional systems of medicine (Raina, M.K. 1982, Onayade et al. 1996, WHO 1999). Aloes have been transferred from their native locations in Africa and are now cultivated and processed for commercial drug aloes in India (Raina, M.K. 1982) and in many parts of the world (Raina, M.K. 1982, WHO 1999). Ethnomedical practitioners in Zimbabwe use the aloe for the alleviation of many ailments, but the plant is not being commercially exploited despite its abundance on the country side. It makes commercial and medicinal sense to exploit the medicinal plants the region is so abundantly endowed with. The critics of the Zimbabwe ethnomedical practices ought to take time to consider how biomedicine developed to its present levels, then devise ways to develop their own ethnomedicine.

Objective 1.

To demystify ethnomedical practices in Zimbabwe and help people appreciate the strengths and weaknesses of ethnomedicine as practiced in Zimbabwe. 2. To document the relationship between ethnomedicine and ethnoreligion in Zimbabwe and highlight gender balance in the systems.

Methodology

This study attempts to explain the relationship between ethnoreligion and ethnomedicine in Central Africa through interviewing some leading Spirit Mediums in a qualitative study in which the sampling was purposive, taking place between 2001 and 2006, in Chiweshe District in the Mashonaland Central Province, north of Harare, and in Harare. Chiweshe was chosen because of the concentration of leading spirit mediums in that region. Many people flock there from all over Zimbabwe and across the borders to consult the spirit mediums. The results of this study are generalizable over Central Africa because the spirit mediums have collaborators all over Central Africa and claim that their spirits know no boundaries. Harare was chosen because of its central location. Questions included the nature of spirit mediums, their responsibilities as regards ethnomedical practices, the influence of ethnoreligion on ethnomedicine, the history of ethnomedicine, the relationship of men and women in these cultural practices and the way forward. Sample selection was guided by consideration of information richness. The purposive sampling led to six spirit mediums in Chiweshe (4 men and 2 women), and two spirit mediums in Harare (1 man and 1 woman) being interviewed, each on several occasions, over the study period. All the spirit mediums who were invited to take part in the study accepted. Member checking was done during the course of the study to inquire whether the views of the spirit mediums were being faithfully interpreted, and to ascertain whether the results of discussions made sense to all participants. Data collection and analysis took place until analytic saturation was reached. The spirit mediums were interviewed both when possessed and when apparently free from the influence of the spirit. Interviews of possessed mediums were not planned. If and when a planned visit coincided with spirit possession, the opportunity was made use of and interviews were conducted. Each of the eight mediums was interviewed under possession on at least two occasions and the mediums were happy to be told that such an opportunity had availed itself and the medium assisted with explanations which helped considerably during data interpretation. Some of their explanations were more elaborate when possessed than when not. There was no serious contradiction between what was said when possessed and what was said when apparently free from the influence of the spirit. The more senior the spirit mediums the more interview time they occupied, the greater the number of times they were interviewed and the greater their contribution to the final results of the study. When there was conflict between data from different spirit mediums, the data were discussed with different mediums and further explanation sought. In general, disagreements were not of fact but of interpretation. Further discussions and member checking led to resolution of the disagreements. Data interpretation, triangulation and authentication were on going. The gender composition of the sample of spirit mediums was not a result of a conscious decision by the researcher. It just happened that there were more male famous spirit mediums in Chiweshe than there were female. The choice of mediums in Harare was a result of recommendations spirit mediums from Chiweshe who suggested six names from whom the two were chosen on the basis of popularity with no conscious decision on gender balance.

Results and Discussion

The spirit mediums claim that before the colonial era in Zimbabwe the African people had a religion with the same principles as are found in the Old Testament. They believed in creation, life after death, the existence of angels, the Ten Commandments and reward for proper behaviour in life. The biblical names had their Shona translations. God was known as Murenga or Mwari; Adam as Munhumutapa; Noah as Nohoreka; etc. In agreement with Sindiga (1995) there has always been a hierarchy of spirit mediums: (1) Gombwe, (2) Sadunhu or Sadzinza, (3) Tateguru, (4) N'anga, and (5) Shave, the levels differing in the way they practice medicine, as well as the origin and power of the spirit{s} that possesses them. There is a decline in the medium's concentration on the spiritual aspects of ethnomedicine as one goes down the ranks, just as there is an increase in the reliance on herbal remedies as one goes down the ranks. There are more males in the higher ranks than there are females.

(1)Gombwe Gombwe, the highest level of spirit mediums, is a medium of the angel of God, not a spirit of a dead person as is generally believed. The spirit that possesses the Gombwe is a messenger of God which looks after the state of the world, reports to God and receives and transmits God's wishes to the world. Both males and females may occupy this level. Examples of such mediums are Chaminuka, Kaguvi, Dzivaguru, and Nehanda. The spirits that possessed these mediums did not belong to the clans of the respective mediums, but to the region. The same spirit can possess and talk on different people and in different regions of the world at the same time but the power of the spirit will be most concentrated on one medium and the spirit will be known by different names based on the languages of the people involved. The mediums were quick to point out that Whites do not respect this but it is respected in African ethnoreligion. They said that in times of hardship, say illness, God will tell the angel why he has unleashed the scourge on to the world and through the medium the angel will tell people what God expects of them. The Gombwe pleads with God in prayer on behalf of the people and if God sees the people complying with his wishes the illness will disappear. It is believed that God will allow people to suffer for a variety of reasons such as breaching socio-religious obligations (for example failure to respect the dead, sacred places, days of holiness; indulgence in promiscuity, disrespectful of elders and the murdered), and taboos (for example having sexual intercourse between relatives or committing suicide, killing sacred animals such as pythons, beating up parents especially mothers, intermarriage within clan members, and desecrating sacred places).The Gombwe intervenes between God and people, for the benefit of people. Using the right channels people can ask Gombwe to plead with God on their behalf and God will advise the Gombwe on what people can do to gain his forgiveness and reclaim their peace. Thus, as pointed out by Ndeti (1996) some ethnomedical practices include the provision of the means for atonement and intercession with the world of the spirits. The spirit mediums of this level play different roles, for example Chaminuka is associated with rains and wars among other responsibilities and Nehanda is associated with the plight of women and wars. The males may support waging of a war for a cause, but Nehanda may intervene and plead with the males against war reminding the males that as the bearer of children she knows what is best for her children. It is believed that Nehanda, like most other female spirit mediums at this level, will support war only when there is no choice, being contend to plead with the male counterparts for mercy and harmony in society and generally remaining in the background. The spirits of the level of Gombwe are not equal. There are the very powerful and the not so powerful. The medium of the big one is always surrounded by mediums of smaller ones (male and female), regardless of whether the big one s male or not. The smaller ones will be given duties dependent on the seniority of the spirits that possess them. Some will function as herbal experts. Some will be close to the Gombwe, helping to direct activities of the vicinity. The very junior ones will be relegated to performing manual duties for the upkeep of the organization. Where as there are very few females at the level of the big Gombwe, the big Gombwe is usually surrounded with more females than males regardless of whether the big one is male or female. This distribution of gender is not a result of conscious decision by the people in charge, it just happens that there are more females who get possessed than there are males. The large concentration of female inmates does not lead to sexual harassment by the male inmates. The people around the Gombwe are expected to have high moral values. Those who want to marry must do so properly according to cultural values, and most of the members that I met are in monogamous marriages.

2) Sadunhu Sadzinza is the spirit medium of the original leader of a clan. The spirit mediums concurred that clans were formed when people were still in Guruuswa, Tanganyika, now mainland Tanzania. At first they were only twelve and were led by males. They later increased as people were further divided through wars and marriages. The spirits of the original leaders of clans are referred to as maSadzinza. They look after the general interests of the members of their clans and of the people living within the clans. They report to maGombwe and take messages from maGombwe to their people through chiefs and vice versa. MaGombwe and maSadzinza do not charge clients for their ethnomedical services and live on gifts from well-wishers. The strength of the spiritual powers of the Sadzinza will depend on how strong the original leader of the clan was and on the medium's state of holiness. Thus ethnoreligion and ethnomedicine are inseparable and are wholesome in approach (Ndeti, K. 1996). Laxity in holiness leads to decline of powers or even death of the medium and the spirit chooses another medium from the clan, and not necessarily from the same family. Because the original leaders of clans were male, most of the mediums at this level are male, although inheritance of the spirit from a male to a female medium has happened in some cases.

3) Tateguru The third level of spirit mediums is Tateguru (the spirit of a family's great grand-parents). These look after the interests of the families they left behind, and endow their mediums with survival means, usually in the form of ethnomedical practices. Their spiritual powers emanate from the Sadzinza. Closely related to these are the Sekurus and the Mbuyas (grandfathers and grandmothers, respectively). These possess members of the families they left behind, especially the young ones. The Sadzinzas, Sekurus and Mbuyas come back so that the living can help them cleanse themselves of their wrongs. They possess their mediums and confess of the murders, adulteries, robberies, incest, living with a woman without paying compensation to her parents, or complain of the wrongs done to them in life such as plunder of resources by people known or unknown to them, being made slaves, or being made to work without proper re-numeration or losing their wife to others or losing their wealth to relatives of the husband or wife. Unlike the Tateguru, Sadzinza, and Gombwe, the spirits of grandparents do not possess their mediums permanently. They disappear upon solution of the problems. Solutions include restitution which may involve payment of large amounts of wealth to the aggrieved parties. The illness which may have played havoc on the spirit medium and his/her relatives disappears. But before it disappears it facilitates learning of what should be done and what should not be done by family members, and foretelling of events. The spirit will work for the well being of the family. All those who take part in the cleansing of the spirit receive rewards commensurate with their level of involvement during spirit cleansing. When cleansing is complete, the spirit will join the spirits of ancestors in the state of happiness. From this state, they may be assigned duties as Tategurus depending on their statuses before death. Spirit cleansing is important in African ethnomedicine. Non-Africans will send a murderer to jail and the murderer will be free after the end of the jail term. Africans contend that sending a murderer to jail does not give anything to the victim. Vengeance (ngozi) still has to follow and cause restitution. Ethnoreligion contends that when a person dies the spirit joins those of the ancestors in a state of happiness. Reaching this state is not automatic. The dead have to answer for what they did when they were still alive: how they handled their property, the property of the family and that of the neighbours and strangers; how they treated family members, neighbours, strangers; etc. If their accounts are not satisfactory, they are sent back to correct their mistakes. The spirit of the dead person will possess relatives, causing illness and suffering to gain attention. No medicine can end the illness and suffering, apparently in agreement with Sindiga (1995) on the treatment of human-induced illnesses which must be referred to ethnomedical practitioners. The only cure is restitution, after which, the spirit is allowed to join the company of ancestral spirits (maTateguru), a situation akin to heaven in Christendom, and the period of vengeance and restitution being analogous to purgatory. In general, the spirits of dead females are expected to possess female members of the families, but those of males may possess either sex.

(4) N'anga The fourth level of spirit mediums are the N'angas (herbal experts), highly populated by both males and females. These are the "real traditional healers". They receive their powers from maGombwe through maSadzinza. This study revealed that problems arose with the advent of the cash economy. Some of the maGombwe and maSadzinza started behaving like N'angas and charge clients for ethnomedical services. Their spiritual powers and their efficacy at servicing the N'angas declined, to the detriment of both the N'angas and themselves. At present a few spirit mediums are practicing as maGombwe or maSadzinza. Most, especially those in cities and towns, are practicing as N'angas. The Gombwe, the Sadzinza and the Tateguru do not use divining gadgets (Binsbergen, W.V. 1995). Their divination protocols are more complicated as the spirit possesses the medium and makes him/her see into the past, present, and future, then act including prescribing solutions to illness and other problems. They rely on prayer, sacrifice and religious teachings to solve illness and other problems then refer patients to N'angas for herbal treatment, if necessary. The divination of the N'anga is more straightforward as he/she relies mostly on his/her divining gadgets to discover what medicine to prescribe and how to administer it. Besides receiving powers from the Gombwe, the Sadzinza, and the Tateguru, he/she also receives powers from maShave (spirits associated with some animals). Examples of mashave are shave regudo (of a baboon) which causes the medium to behave like a baboon; shave rembada (of a leopard) which causes the medium to behave like a leopard; etc. These are spirits which were created to behave like the respective animals. They are not spirits of the dead animals. These spirits are particularly good for foretelling and explaining illnesses and disasters. It is said that they can even increase the efficacy of herbal medicines. This would explain why some medicines are said to cure dependent on who prescribed or administered it and is another illustration of the interdependence of ethnoreligion and ethnomedicine. The ethnomedical practitioner transcends the limits of the molecular approach into the powerful influences and interplay of an individual with his/her environment recognizing that human beings are constituted of psychic and physical realities which are distinct and not separate (Ndeti, K. 1996). There are good and there are bad mashave. There are ways to cleanse both the medium and the spirit of bad mashave. The good ones (the talents) include the talent to cure, the talent to hunt, to work, to fight, and to lead. The bad ones (the demons) include those for witching, prostitution, theft, murder, lying. Cleansing removes the bad ones and strengthens the good ones. The question of mashave is further complicated by the fact that at each level in the hierarchy of spirit mediums there are mashave associated with that hierarchy. There are mashave associated with the Gombwe, or with the Sadunhu, or with the Tateguru, or with the N'anga, or with the herbalist. The same type of mashave will perform the same type of functions at the different levels but with different powers dependent on the hierarchical level they are associated with. The N'anga uses herbal medicines to cleanse. The Gombwe does so through prayer and sacrificial activities as well as through the use of herbs and is generally considered more successful at such cleansing. In their activities, the Gombwe relies more on spiritual powers than on herbal powers, just as those at the bottom of the hierarchy rely more on herbal powers than on spiritual powers. There is some sort of gradual change in the relative effectiveness of the spiritual versus the herbal powers as one goes up or down the hierarchy. Thus in Zimbabwe, as is the case in other countries on the African continent, religion and medicine are inseparable. Some illnesses are curable through religious considerations and others, through herbal medicine. Of the ethnomedical procedures, the activities of the N'anga (the ethno-medical expert) may be considered the closest to biomedical activities as the N'anga relies on whole plant or parts of plant, or on other organisms as sources of curative agents, just as the biomedical practitioner relies on chemicals derived from plants and other organisms and from synthesis. But the N'anga should not be viewed in isolation. His/her activities are influenced by the strata above his/hers. The theories and concepts of prevention, diagnosis, improvement and treatment of illness in ethnomedicine historically rely on holistic approaches towards the sick individual. Most systems of ethnomedicine may use herbal medicines or socio-religion based therapies along with certain behavioural rules (WHO 2000). Holism is a key element of all systems of ethnomedicine (WHO, 1993 and 2000). In his/her practices, the N'anga calls upon the powers and experiences bestowed on him/her by the spirits who in turn maintain him/her in touch with powers up in the hierarchy. Training Unlike the practice in biomedical systems, one does not choose to be a spirit medium. The choice is made by the spirit and the chosen medium cannot say no. The chosen person then spends many years of apprenticeship under a renowned spirit medium, receiving guidance and cleansing until he/she can run his/her own practice and eventually guide others to do the same. Success will depend on how well he/she keeps the rules and regulations of the calling. The medium, in the case of an N'anga, is destined to become an ethnomedical expert. The powers of the spirit are complemented by those of mashave. The medium has to learn the art of divining using divining gadgets (Binsbergen W.V., 1995). The potential is already bestowed upon him/her by the spirit. He/she joins an established practitioner for cleansing and apprenticeship which will be as long as it takes to satisfy the mentor that he/she is ready to practice independently. It is believed that the spirit will guide the medium in the choice of the appropriate mentor. The period of apprenticeship is not always spent with the same mentor. The medium might move to another mentor when satisfied that there is no further help obtainable from the current mentor or the current mentor might arrange for secondment with another. By the time apprenticeship is over, the practitioner is already an expert in his/her own right. The training is very much unlike that of biomedical practitioners who acquire the basic skills through an intensive and selective education, specializing in related medical disciplines. The training of African ethnomedical practitioners is through observation and a long and tedious apprenticeship system involving intervention of spirits and ethno-socio-curricula activities and is bound to be ethnocentric (Waane, S.A.C. 1990) and thus very much unlike the training of the biomedical personnel.

Herbalists Below the rank of N'angas are the herbalists. These are not spirit mediums. They are people who have learnt the different herbs through association with the Gombwe, or Sadzinza, or Tateguru, or N'anga, as they help them collect and prepare herbal medicines and perform other duties. They may have been directed into the associations by their own mashave. This group of ethnomedical practitioners do not use divining gadgets. Some of them become very powerful herbalists, as a result of training efforts. In principle a N'anga advises patients with difficult human-induced illnesses to go to the Gombwe and those with difficult natural illnesses either to the Gombwe or to Biomedical practices. The patient does not necessarily tell the Gombwe that he/she was sent to him by so and so. The Gombwe will know the purpose of the visit and does what the n'anga was unable to do and advises the patient to go back to him/her. Those advised to go to biomedical practices will voluntarily return to the N'anga when they have finished with the biomedical practitioners. The spirit mediums concurred that their patients move between biomedicine and ethnomedicine even for the same illness at the same time depending on what they perceive to be the source of the problem, using the two systems in a complementary or supplementary way, thus in agreement with (Sindiga, L. 1995). The bond between the ethnomedical practitioner and the patient lasts even long after the illness has disappeared. The spirit mediums concurred that people visit ethnomedical practitioners even during the times they are consulting biomedical practitioners. They want to try both ethnomedicine and biomedicine simultaneously. They trust ethnomedical practices and have faith in ethnomedicines. They say that people go to biomedicine only when they have to. These sentiments by spirit mediums vindicate similar statements in the literature 2, 3 on the question of cultural bonds between ethnomedical practitioners and their patients. An N'anga has an arsenal of herbal plants that cure or alleviate illnesses. But a real N'anga is honest and does not claim to have solutions to all problems. He/she acknowledges the strengths of others. An n'anga may become greedy and waste a patient's time and money giving the patient what is not useful in an attempt to rip him/her off. Such N'angas will be punished, their powers decline, their practices falter and patients stop consulting them. The spirit mediums claimed that in the past the N'anga and the Gombwe could cure most illnesses. It is believed that their success depended on how far they kept rules. Failure to adhere to rules resulted in the decline of their powers. It has been widely believed that "whatever the Gombwe could not cure no one else could". Spirit mediums believe that people used to live long because they used to behave according to God's wishes who in turn answered their prayers. On the diseases which are incurable through biomedicine and ethnomedicine, the mediums believe that cooperation between the two systems could solve the problem. A hindrance to such cooperation is the lack of trust on the part of the ethnomedical practitioners who fear that all benefits would go to biomedicine whilst they would not gain much. They claim that biomedical personnel have always asked for their secrets and disappeared without giving them anything in return. They lament the non-availability of people who are prepared to enter into serious collaboration with them for the benefit of both sides.

Collaboration is a natural aspect of a spirit medium's life. Each one of them has other mediums with whom he/she voluntarily shares the secrets of the trade .They call them maSahwira. Ethnomedical practitioners fear that biomedicine, with its powerful machinery, would steal their medicines. Dispelling such fears would advance the cause for collaboration. The spirit mediums believe that there will eventually be honest people who will develop ethnomedicines along the way biomedicines have developed. Summary The study revealed the strong dependence of ethnomedicine on ethnoreligion. Most of what an ethnomedical practitioner does can be traced to the influence of and control by the ancestral spirits. Although the spirit mediums kept referring to the good old days when people respected and obeyed rules, it was abundantly clear that they appreciated the changes in people's attitudes with time. They realized the dynamic nature of culture and proposed changes which might have been thought to be unattainable a few years ago, just as ethnomedicine is part of culture which itself is always getting modified with time (Sindiga). For example their ideas about collaboration are contrary to what would be expected in connection with the preservation of cultural secrets. Ethnomedical practitioners have been known to cling to secrecy about their medicines. But they are now willing to open up and allow others to develop ethnomedicines. They were quite willing to tell me the nature of their different medicines as long as I would not use the information for personal gain. The study also revealed that in Zimbabwe, ethnomedicine is alive and well in the custodianship of spirit mediums. They claim that the colonial era dislocated it and hindered its development, but failed to destroy it and it can still be rehabilitated and be allowed to resume its role in society. In Zimbabwe, removal of oppressive laws such as the witchcraft suppression act will allow people to openly talk about ethnomedicine and be knowledgeable about its strengths and weaknesses. People can then make informed choices on the medical system to consult in time of need. Development of the ethnomedical system will ease the burden on the hospitals and clinics of the biomedical system. Research on ethnomedicines will enrich biomedical practices. Modalities to allay the fears of ethnomedical practitioners have to be established so that their cooperation on collaborative research on ethnomedicines can be gained. Cooperation between biomedicine and ethnomedicine will benefit the two systems and the community as a whole. This study spelled out the strata of spirit mediums, their responsibilities, and the origins of their powers. It further clarified some misconceptions regarding the nature of mashave. Many people say that mashave are spirits of animals and of non-relatives. The study points out that these are spirits which were created for the purposes they serve and that they are not spirits of the dead. Conclusion In all my interactions with the spirit mediums and the people who work with them, I did not come across anything that would suggest uncleanliness, unhygienic and unscientific practices associated with their preparations of medicines. The same care they exercise in the preparation of their food is the care they exercised in the preparation of the medicines. Neither was there anything to suggest lack of scientific considerations in their handling, preparation, and administration of medicines. The ethnocentric nature of ethnomedicine might have contributed to the relaxation of the patients whom I met when I visited the spirit mediums, for the patients must have felt that they where part of the system. The relaxation was also evident as the patients consulted the spirit mediums and the positive effect of ethnoreligion on ethnomedicine was equally evident. The feelings of spirit mediums in connection with collaboration with biomedicine must be taken seriously, remembering that ethnomedicine is not likely to gain as much as biomedicine would gain from the collaboration. Acknowledgements The author is grateful to the 8 spirit mediums who took part in this study and selflessly permitted him to interact with them and their assistants throughout the period of the study.

Glossary Chaminuka, Dzivaguru, Kaguvi, Nehanda are some of the most revered spirit mediums in the history of the Shona people of Zimbabwe. Gombwe Shona name for the highest spirit medium for which the spirit is not of a dead person. This is not an ancestral spirit, but believed to be a spirit created for the purpose maGombwe Plural of the word Gombwe. maSadunhu Plural of sadunhu maSadzinza Plural of sadzinza Mashave The spirit which possess these are spirits which where created for the service of people. They are not spirits of dead animals or of living animals. These spirits render the people they possess to behave like animals when they are possessed, hence they are erroneously thought to be spirits of animals. A person possessed by any of these spirits will behave like the animal associated with the spirit. For example a person possessed by shave rebveni behaves like a baboon. Bveni is the shona name for a baboon. The spirit just renders the medium behave like a baboon but the spirit did not come from a dead baboon. The spirit was created to be like that. There are many animals associated with such spirits. These spirits are not limited to animals. They can be associated with anything else. maTateguru Plural of Tateguru Mbuya Grandmother N'anga Spirit medium who is also a herbalist who charges clients for services. Most traditional healers belong to this group. These are the real herbal practitioners. Most of their powers emanate from the medicines they possess Their spiritual powers are considered to be much less than those of the Gombwe and of the Sadunhu. N'ozi Spirits associated with people who must be compensated for something bad that was done against them. They may be spirits of dead people who come back for vengeance. They return to cause the wrong doer or relatives of the wrong doer to pay compensation to their families. The level of compensation depends on the severity of the "crime". Sadunhu This word is synonymous with Sadzinza. This the founding leader of a clan. The Shona people believe that clans were started when they moved to Southern Africa from the North. As they moved from Egypt they settled around the area of the Great Lakes for a while. It was during that time that they devided themselves into clans to facilitate marriage. Originally twelve clans were created. The number increased as need for intermarriage arose and also because of wars. Sekuru Grand father Tateguru Great grand parent usually in an extended family. Plural for the word is maTateguru. Sahwira A family or extended family friend. Shave Singular of mashave

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