How and When Do People Move between Traditional and Modern Medicine in Post-Disaster Settings?

Background: In post-disaster settings across the world, humanitarian aid organizations have provided Western modern medical services. However, some of such services have been reported to neither exactly match local needs nor be sustainable in Asia and Africa. Recently, increasing attention has been paid to traditional and informal care practices that play a role in providing primary healthcare in disaster-affected communities.

Aim: This study aims to explore the role and limitations of traditional medicine and informal care practices in Rwanda and Japan and investigate how local people are moving between different healthcare systems in post-disaster settings.

Methods: A review of empirical reports from Japan after natural disasters and ethnographic fieldwork in Rwanda after war and genocide were completed as part of a larger qualitative study of community resilience. Collected data were analyzed by using techniques of grounded theory and narrative analysis.

Findings: Informal care and traditional medical practices provided primary healthcare in response to local health needs after disasters in Rwanda and Japan. Findings from fieldwork in Rwanda revealed that local communities assisted members’ healing process through providing economic, social, mental and spiritual support in everyday life. However such informal care practices also had limitations. One clear limitation was that communities were incapable of dealing with severe mental illness and took patients to traditional medicine (‘prayer’) or Western medicine (‘testing’). Meanwhile, in Japan, somatic pain is significant suffering among disaster survivors but it was left behind the triage system of Western modern medicine in emergency. Survivors thus sake traditional medicine to mitigate their pain.

Discussions: Local survivors make sense of their suffering and pain and seek treatments based on blended theories of Western, traditional and ethno-medicine. Further research to explore boundaries of different healthcare systems is needed to develop healthcare services and policy that fit local needs.