Practices and Perspectives of Traditional Bone Setters in Northern Tanzania

Background: Traditional health practitioners remain a critical source of care in Tanzania, more than 50% of Tanzanians frequently using their services. With a severe shortage of orthopaedic surgeons (1:3.3 million Tanzanians) traditional bone setters (TBSs) could potentially expand access to musculo...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Elizabeth B. Card, Joy E. Obayemi, Octavian Shirima, Matayo Lazaro, Honest Massawe, John W. Stanifer, Ajay Premkumar, Neil P. Sheth
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	traditional medicine, traditional healers, bone setting, international health, global surgery, sub-saharan africa, trauma, orthopaedics Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/353dc3ee97354e4a982d3b2cd8872e6a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:353dc3ee97354e4a982d3b2cd8872e6a
record_format	dspace
spelling	oai:doaj.org-article:353dc3ee97354e4a982d3b2cd8872e6a2021-12-02T12:23:25ZPractices and Perspectives of Traditional Bone Setters in Northern Tanzania2214-999610.5334/aogh.2878https://doaj.org/article/353dc3ee97354e4a982d3b2cd8872e6a2020-06-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2878https://doaj.org/toc/2214-9996Background: Traditional health practitioners remain a critical source of care in Tanzania, more than 50% of Tanzanians frequently using their services. With a severe shortage of orthopaedic surgeons (1:3.3 million Tanzanians) traditional bone setters (TBSs) could potentially expand access to musculoskeletal care and improve outcomes for morbidity as a result of trauma. Objective: We sought to identify the advantages and disadvantages of traditional bone setting in Tanzania and to assess potential for collaboration between TBSs and allopathic orthopaedic surgeons. Methods: Between June and July 2017 we interviewed six TBSs identified as key informants in the regions of Kilimanjaro, Arusha, and Manyara. We conducted semi-structured interviews about practices and perspectives on allopathic healthcare, and analyzed the data using a deductive framework method. Findings: The TBSs reported that their patients were primarily recruited from their local communities via word-of-mouth communication networks. Payment methods for services included bundling costs, livestock barter, and sliding scale pricing. Potentially unsafe practices included lack of radiographic imaging to confirm reduction; cutting and puncturing of skin with unsterile tools; and rebreaking healed fractures. The TBSs described past experience collaborating with allopathic healthcare providers, referring patients to hospitals, and utilizing allopathic techniques in their practice. All expressed enthusiasm in future collaboration with allopathic hospitals. Conclusions: TBSs confer the advantages of word-of-mouth communication networks and greater financial and geographic accessibility. However, some of their practices raise concerns relating to infection, fracture malunion or nonunion, and iatrogenic trauma from manipulating previously healed fractures. A formal collaboration between TBSs and orthopaedic surgeons, based on respect and regular communication, could alleviate concerns through the development of care protocols and increase access to optimal orthopaedic care through a standardized triage and follow-up system.Elizabeth B. CardJoy E. ObayemiOctavian ShirimaMatayo LazaroHonest MassaweJohn W. StaniferAjay PremkumarNeil P. ShethUbiquity Pressarticletraditional medicine, traditional healers, bone setting, international health, global surgery, sub-saharan africa, trauma, orthopaedicsInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	traditional medicine, traditional healers, bone setting, international health, global surgery, sub-saharan africa, trauma, orthopaedics Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	traditional medicine, traditional healers, bone setting, international health, global surgery, sub-saharan africa, trauma, orthopaedics Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Elizabeth B. Card Joy E. Obayemi Octavian Shirima Matayo Lazaro Honest Massawe John W. Stanifer Ajay Premkumar Neil P. Sheth Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
description	Background: Traditional health practitioners remain a critical source of care in Tanzania, more than 50% of Tanzanians frequently using their services. With a severe shortage of orthopaedic surgeons (1:3.3 million Tanzanians) traditional bone setters (TBSs) could potentially expand access to musculoskeletal care and improve outcomes for morbidity as a result of trauma. Objective: We sought to identify the advantages and disadvantages of traditional bone setting in Tanzania and to assess potential for collaboration between TBSs and allopathic orthopaedic surgeons. Methods: Between June and July 2017 we interviewed six TBSs identified as key informants in the regions of Kilimanjaro, Arusha, and Manyara. We conducted semi-structured interviews about practices and perspectives on allopathic healthcare, and analyzed the data using a deductive framework method. Findings: The TBSs reported that their patients were primarily recruited from their local communities via word-of-mouth communication networks. Payment methods for services included bundling costs, livestock barter, and sliding scale pricing. Potentially unsafe practices included lack of radiographic imaging to confirm reduction; cutting and puncturing of skin with unsterile tools; and rebreaking healed fractures. The TBSs described past experience collaborating with allopathic healthcare providers, referring patients to hospitals, and utilizing allopathic techniques in their practice. All expressed enthusiasm in future collaboration with allopathic hospitals. Conclusions: TBSs confer the advantages of word-of-mouth communication networks and greater financial and geographic accessibility. However, some of their practices raise concerns relating to infection, fracture malunion or nonunion, and iatrogenic trauma from manipulating previously healed fractures. A formal collaboration between TBSs and orthopaedic surgeons, based on respect and regular communication, could alleviate concerns through the development of care protocols and increase access to optimal orthopaedic care through a standardized triage and follow-up system.
format	article
author	Elizabeth B. Card Joy E. Obayemi Octavian Shirima Matayo Lazaro Honest Massawe John W. Stanifer Ajay Premkumar Neil P. Sheth
author_facet	Elizabeth B. Card Joy E. Obayemi Octavian Shirima Matayo Lazaro Honest Massawe John W. Stanifer Ajay Premkumar Neil P. Sheth
author_sort	Elizabeth B. Card
title	Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
title_short	Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
title_full	Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
title_fullStr	Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
title_full_unstemmed	Practices and Perspectives of Traditional Bone Setters in Northern Tanzania
title_sort	practices and perspectives of traditional bone setters in northern tanzania
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/353dc3ee97354e4a982d3b2cd8872e6a
work_keys_str_mv	AT elizabethbcard practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT joyeobayemi practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT octavianshirima practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT matayolazaro practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT honestmassawe practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT johnwstanifer practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT ajaypremkumar practicesandperspectivesoftraditionalbonesettersinnortherntanzania AT neilpsheth practicesandperspectivesoftraditionalbonesettersinnortherntanzania
_version_	1718394446769291264

Practices and Perspectives of Traditional Bone Setters in Northern Tanzania

Ejemplares similares