La structure multidimensionnelle de guerison a Kinshasa, capitale du Zaire

Abstract

The sick of Kinshasa, capital city of Zaire, have at their disposal an array of both official hospital and traditional medicine options. However, because of the rapid post-independence population influx to the city, increasing the population from 400,000 to over 2 million inhabitants since 1960, and only a 50% increase in hospital and biomedical facilities in that time, as well as the continued preference for some African treatments, these latter remain an important health care resource in the city. Nearly half of the city's population is from the immediate Lower Zaire area, thus the Kongo medical system is the prevalent overall medical culture in terms of recourse to treatment. The Kongo medical culture is multidimensional in its range of diagnoses, preventions, or elimination of disequilibriums of a physical, mental or social character. Etiological categories are based upon a distinction between normal and abnormal causes. Therapies range from the physiological to the psychological. This Kongo medicopsychotherapeutic culture is carried out by several levels and types of practitioners, including profane herbalists, nurses and doctors with varying degrees of formal training in the use of biochemical drugs (of fluctuating availability because of economic uncertainty), and clairvoyant psychotherapies by a series of practitioners who deal with afflictions caused by ancestors, witchcraft, and other spirits including those of ‘medicines’. These clairvoyant practitioners often practice on a one-to-one basis with clients, but there are also group therapeutic rites—e.g. Zebola, Bilumbu, Mpombo, Mizuka—and spiritual healing churches led by Christian prophets. This broad-ranging medical culture in an urban setting reflects the diversity of the society and a wide range of responses to problems.