The relevance of traditional medical cultures to modern primary health care

This paper attempts to identify forms of traditional medicine which have the greatest potential for advancing primary health care goals. It begins by differentiating traditional medical systems into types. according to the kinds of medical knowledge which they depend on for preventing, diagnosing, and treating sickness. Emphasis is given to the facts that some traditional systems concentrate on producing varieties of pathophysiological knowledge, while others focus on forms of etiological knowledge; and that some traditional systems accumulate the medical knowledge which they produce, while others diffuse and fragment it. These differences give clues to a medical tradition's abstract potential for achieving three distinct, and only sometimes linked, ends: curing disease, healing illness, and enhancing the productivity of official primary health care programs. To make these clues concrete, it is also necessary to know something about the different ways in which traditional medical beliefs and practices are embedded, together with modern (cosmopolitan) medicine, in actual patterns of resort. The remainder of the paper assesses the relevance, for advancing primary health care goals, of particular classes of traditional healers--e.g. herbalists, midwives, bonesetters--and technologies within different types of medical systems. Four possibilities are described; integration, complementarity, rivalry and intercalation.